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Epilepsy & Behavior Case Reports

Pegah Afra, Verena Clarissa Samara, Lilly Fagatele, Bola Adamolekun
"Burst-suppression" pattern consists of complete attenuation of background between bursts of mixed frequencies, variable morphology and waveforms. It is a subgroup of periodic patterns seen in severe cerebral damage, anesthesia or prematurity. Here, we present a 46-year-old woman with post-anoxic encephalopathy on cooling protocol with two electrographically similar patterns of burst-suppression (one with a clinical ictal correlate of isolated eye movements), as well as three electroclinical seizures...
2019: Epilepsy & Behavior Case Reports
Mihoko Kawai, Kousuke Kanemoto
We report a case of auditory disturbance in an adult female that developed after starting lacosamide treatment for epilepsy. While carbamazepine is known to change auditory pitch perception in some patients, that has not been previously reported as a side effect of lacosamide administration. In our description of pitch perception deficit associated with lacosamide, we outline features seen in our patient and compare our findings with those of previous reports describing carbamazepine-associated auditory disturbance...
2019: Epilepsy & Behavior Case Reports
Satoru Ikemoto, Shin-Ichiro Hamano, Yuko Hirata, Ryuki Matsuura, Reiko Koichihara
We retrospectively investigated whether perampanel (PER) could serve as an alternative for treating drug-resistant seizures in lissencephaly. We investigated the following data: age at onset of epilepsy, age at start of PER, etiology, brain MRI findings, seizure type, seizure frequency, adverse effects, and concomitant anti-epileptic drugs. There were 5 patients with lissencephaly, including 2 with Miller-Dieker syndrome. Four out of five patients exhibited ≥ 50% seizure reduction. Myoclonic seizures disappeared in 1 patient...
2019: Epilepsy & Behavior Case Reports
Yongxin Li, Ya Wang, Zhen Tan, Qian Chen, Wenhua Huang
The main focus of the present study was to explore the longitudinal changes in the brain executive control system and default mode network after hemispherotomy. Resting-state functional magnetic resonance imaging and diffusion tensor imaging were collected in two children with drug-resistnt epilepsy underwent hemispherotomy. Two patients with different curative effects showed different trajectories of brain connectivity after surgery. The failed hemispherotomy might be due to the fact that the synchrony of epileptic neurons in both hemispheres is preserved by residual neural pathways...
2019: Epilepsy & Behavior Case Reports
C Ákos Szabó, Rachel Garvin, Shaheryar Hafeez, Ali Seifi, Linda Leary, Ratna Bhavaraju-Sanka, James M Henry, Alex M Papanastassiou
We describe a 23-year-old woman with previous right temporal lobe surgeries for underlying cortical dysplasia, presenting with drug-resistant right hemispheric seizures and epilepsia partialis continua (EPC). After anti-seizure medication adjustments, she developed focal status epilepticus with progressive EEG and neuroimaging changes. Cerebrospinal fluid and serum autoimmune panels were negative except for an elevated serum acetylcholine-receptor antibody titer, but she underwent immunosuppressive therapy...
2019: Epilepsy & Behavior Case Reports
Devon M Kollmyer, Kyla E Wright, Nicole M Warner, Michael J Doherty
Mortality associated with cannabis used for treatment of epilepsy is not well documented. We discuss two fatalities in the setting of epilepsy and self-determined therapy with cannabis (SDTC). One patient had probable sudden unexpected death in epilepsy, the second death was due to seizure-associated drowning. Both directed SDTC over conventional anti-seizure medications. Where recreational cannabis is legal, decisions to use cannabis are often self-directed and independent of physician advice of cannabis risks, in part because physicians may not be aware of the risk of SDTC...
2019: Epilepsy & Behavior Case Reports
Wenyang Li, Lakshman Arcot Jayagopal, Olga Taraschenko
Ictal syncope is a rare phenomenon that occurs in association with 0.002-0.4% of seizures. In the absence of other symptoms, seizures presenting with syncope may be challenging to diagnose. We report a case of a previously healthy male who developed recurrent episodes of syncope with postictal confusion and was later diagnosed with temporal seizures. The patient was successfully treated with anti-seizure drugs and placement of a cardiac pacemaker. In a systematic review of literature, we summarize the clinical characteristics of patients with ictal asystole and isolated syncope...
2019: Epilepsy & Behavior Case Reports
Sara Dawit, Shubhang K Bhatt, Devika M Das, Andrew R Pines, Harn J Shiue, Brent P Goodman, Joseph F Drazkowski, Joseph I Sirven
Both variegate and acute intermittent porphyria can manifest with various neurological symptoms. Although acute symptomatic seizures have been previously described, they are typically tonic-clonic and focal impaired awareness seizures. Convulsive status epilepticus and epilepsia partialis continua are rare and have been described on a case report basis. To our knowledge, there are no previously reported cases describing non-convulsive status epilepticus (NCSE) with electroencephalogram (EEG) documentation in the setting of acute porphyria crisis...
2019: Epilepsy & Behavior Case Reports
Katarína Česká, Štefánia Aulická, Ondřej Horák, Pavlína Danhofer, Pavel Říha, Radek Mareček, Jan Šenkyřík, Ivan Rektor, Milan Brázdil, Hana Ošlejšková
Purpose: Autosomal dominant lateral temporal epilepsy (ADLTE) is a genetic focal epilepsy syndrome characterized by focal seizures with dominant auditory symptomatology. We present a case report of an 18-year-old patient with acute onset of seizures associated with epilepsy. Based on the clinical course of the disease and the results of the investigation, the diagnosis of ADLTE with a proven mutation in the RELN gene, which is considered causative, was subsequently confirmed. The aim of this study was to use 3 Tesla (3 T) magnetic resonance imaging (MRI) and advanced neuroimaging methods in a patient with a confirmed diagnosis of ADTLE...
2019: Epilepsy & Behavior Case Reports
Mary Gerges, Laila Selim, Marian Girgis, Amr El Ghannam, Hadeer Abdelghaffar, Ahmed El-Ayadi
Background: Even with the extensive use of ketogenic dietary therapies (KD), there still exist many areas of the world that do not provide these treatments. Implementing the ketogenic diet in different countries forms a real challenge in order to match the cultural and economic differences. Aim: To assess the feasibility of implementing a ketogenic diet plan in a limited resource setting with identification of the compliance, tolerability and side effects in the target population and to assess the efficacy of the ketogenic diet in children with intractable epilepsy...
2019: Epilepsy & Behavior Case Reports
Mario Brinciotti, Francesca Fioriello, Antonio Mittica, Laura Bernardini, Marina Goldoni, Maria Matricardi
The clinical significance of Xp22.31 microduplication is still unclear. We describe a family in which a mother and two children have Xp22.31 microduplication associated with different forms of epilepsy and epileptiform EEG abnormalities. The proband had benign epilepsy with centrotemporal spikes with dysgraphia and dyscalculia (IQ 72), the sister had juvenile myoclonic epilepsy, and both had bilateral talipes anomalies. The mother, who was the carrier of the microduplication, was asymptomatic. The asymptomatic father did not possess the microduplication...
2019: Epilepsy & Behavior Case Reports
Angie Zhang, Daniel F Brown, Efkan M Colpan
Aim: We describe a case of mesial temporal extraventricular neurocytoma (mtEVN) in a 23-year-old male presenting with drug-resistant seizures and review the literature on this rare tumor. Methods: A PubMed search was queried using the MeSH term "neurocytoma" and key search terms "extraventricular", "temporal", and "epilepsy". Titles and abstracts were screened for temporal neurocytomas. References were reviewed to identify further studies...
2019: Epilepsy & Behavior Case Reports
Sallie Baxendale
•The ability to knit may be compromised following a right or non-dominant temporal lobe resection.•Non-lesional patients may be at particular risk.•It is important to disseminate knowledge of impact of epilepsy surgery on specialist skills, via case studies.
2019: Epilepsy & Behavior Case Reports
Takefumi Hitomi, Morito Inouchi, Hirofumi Takeyama, Katsuya Kobayashi, Shamima Sultana, Takeshi Inoue, Yuko Nakayama, Akihiro Shimotake, Masao Matsuhashi, Riki Matsumoto, Kazuo Chin, Ryosuke Takahashi, Akio Ikeda
To clarify the effects of sleep on cortical irritability in benign adult familial myoclonus epilepsy (BAFME), we retrospectively compared epileptiform discharges of electroencephalographies (EEGs) between awake and sleep periods in 5 patients (mean age: 49.6 ± 20.3 years). We also analyzed polysomnography (PSG) of 1 patient. Epileptiform discharges were significantly more frequent during the awake period (1.3 ± 1.2/min) than those during light sleep stages (0.02 ± 0.04/min) (P < 0.05)...
2019: Epilepsy & Behavior Case Reports
Sarah R Garson, Stephen J Monteith, Sheila D Smith, Bart P Keogh, Ryder P Gwinn, Michael J Doherty
Objectives: To examine outcome of bilateral extracranial to intracranial (EC-IC) bypass surgeries for a Down syndrome patient with hard-to-treat epilepsy and moyamoya. Materials and methods: Superficial temporal arteries were anastamosed using an indirect bypass technique to middle cerebral arteries bilaterally to help limit perfusion deficits and seizure controls. Results: Two superficial temporal to middle cerebral artery indirect bypass surgeries were performed within 3 months...
2019: Epilepsy & Behavior Case Reports
Tomotaka Ishizaki, Satoshi Maesawa, Daisuke Nakatsubo, Hiroyuki Yamamoto, Masashi Shibata, Sachiko Kato, Mari Yoshida, Jun Natsume, Minoru Hoshiyama, Toshihiko Wakabayashi
•A drug-resistant epilepsy case showed hypermotor seizures and amygdala enlargement.•Seizure onset zone was the hippocampus, not amygdala, as revealed by SEEG.•The enlarged amygdala pathology was classified as FCD type I.•Selective amygdalohippocampectomy led to good outcomes.
2019: Epilepsy & Behavior Case Reports
Emilija Cvetkovska, William Alves Martins, Jorge Gonzalez-Martinez, Ken Taylor, Jian Li, Olesya Grinenko, John Mosher, Richard Leahy, Patrick Chauvel, Dileep Nair
We describe a patient with unilateral periventricular nodular heterotopia (PNH) and drug-resistant epilepsy, whose SEEG revealed that seizures were arising from the PNH, with the almost simultaneous involvement of heterotopic neurons ("micronodules") scattered within the white matter, and subsequently the overlying cortex. Laser ablation of heterotopic nodules and the adjacent white matter rendered the patient seizure free. This case elucidates that "micronodules" scattered in white matter between heterotopic nodules and overlying cortex might be another contributor in complex epileptogenicity of heterotopia...
2019: Epilepsy & Behavior Case Reports
Jason Lockrow, Hannah Tully, Russell P Saneto
Congenital TORCH infections are a significant cause of epileptic spasms, an infantile epileptic encephalopathy, through disruptions to several pathways in neurodevelopment. Congenital Zika virus has a similar neurotropism to other TORCH agents, and leads to microcephaly, severe neurodevelopmental impairment, and high rates of early onset seizures. Here we report a child with confirmed congenital Zika virus who developed extensor epileptic spasms and hypsarrhythmia associated with a loss of early developmental milestones...
2019: Epilepsy & Behavior Case Reports
Rajsekar R Rajaraman, Raman Sankar, Shaun A Hussain
We present the case of a child with long-standing, super-refractory status epilepticus (SRSE) who manifested prompt and complete resolution of SRSE upon exposure to pure cannabidiol. SRSE emerged in the context of remote suspected encephalitis with previously well-controlled epilepsy. We discuss the extent to which response may be specifically attributed to cannabidiol, with consideration and discussion of multiple potential drug-drug interactions. Based on this case, we propose that adjunctive cannabidiol be considered in the treatment of SRSE...
2018: Epilepsy & Behavior Case Reports
Shunsuke Nomura, Yuichi Kubota, Hidetoshi Nakamoto, Takakazu Kawamata
Vomiting is a typical symptom of cerebellar hemorrhage. Usually only supportive care such as antiemetic drugs are available. A 76-year-old woman presented in a light coma. A head CT demonstrated right cerebellar hemorrhage and the hematoma was surgically evacuated. Her intractable vomiting started 3 weeks after surgery. Because her vomiting was unexplained, we checked her EEG, which demonstrated generalized periodic discharges. We diagnosed her with ictal vomiting. Anti-seizure medication was administered and vomiting was rapidly controlled...
2018: Epilepsy & Behavior Case Reports
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