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Epilepsy & Behavior Case Reports

Lilia Zaporojan, Patricia H McNamara, Jennifer A Williams, Colm Bergin, Janice Redmond, Colin P Doherty
Purpose: This study aimed to determine the rate, cause and management of seizures in the context of potential ART-ASD interactions in a cohort of HIV + individuals. Methods: Records of 604 HIV + patients were reviewed and those reporting epilepsy/seizure diagnosis were further evaluated. Results: This cohort exhibited a seizure rate of 2.4%. HIV + patients treated for epilepsy displayed low serum ASD levels and failed to achieve seizure control...
2018: Epilepsy & Behavior Case Reports
James J Young, Joshua S Friedman, Thomas J Oxley, Christina Palmese, Fedor Panov, Saadi Ghatan, Johanna T Fifi, Lara V Marcuse
The mechanism of amobarbital action during the intracarotid amobarbital procedure is poorly understood. We report a patient case who underwent IAP while implanted with bilateral stereo-EEG. We analyzed the spectral power, phase amplitude coupling, and cluster-phase group synchrony during the procedure. Delta and gamma power increased bilaterally. By contrast, phase amplitude coupling increased only ipsilateral to the injection. Similarly, 4-30 Hz cluster-phase group synchrony declines and gamma cluster-phase group synchrony increases only ipsilateral to the injection...
2018: Epilepsy & Behavior Case Reports
Nilika S Singhal, Adam L Numis, Morgan B Lee, Edward F Chang, Joseph E Sullivan, Kurtis I Auguste, Vikram R Rao
Responsive neurostimulation for epilepsy involves an implanted device that delivers direct electrical brain stimulation in response to detection of incipient seizures. Responsive neurostimulation is a safe and effective treatment for adults with drug-resistant epilepsy, but although novel treatments are critically needed for younger patients, responsive neurostimulation is currently not approved for children with drug-resistant epilepsy. Here, we report a 16-year-old patient with seizures arising from eloquent cortex, who was successfully treated with responsive neurostimulation...
2018: Epilepsy & Behavior Case Reports
Christopher Smelick, Jeffrey W Britton, William O Tatum, Anteneh M Feyissa
Seizure types have been described that do not conform to traditional classification schemes. We present another unusual type characterized by focal onset with secondary generalization, that is followed immediately by continued focal activity that generalizes again without an intervening break. Better understanding of these seizure types may allow improved targeted therapies and help shed light on the mechanistic underpinnings of epilepsy.
2018: Epilepsy & Behavior Case Reports
Robert Fisher, Jing Zhou, Adam Fogarty, Aditya Joshi, Matthew Markert, Gayle K Deutsch, Mariel Velez
We demonstrate feasibility of using high-density EEG to map a neocortical seizure focus in conjunction with delivery of magnetic therapy. Our patient had refractory seizures affecting the left leg. A five-day course of placebo stimulation followed a month later by active rTMS was directed to the mapped seizure dipole. Active rTMS resulted in reduced EEG spiking, and shortening of seizure duration compared to placebo. Seizure frequency, however, improved similarly in both placebo and active treatment stages...
2018: Epilepsy & Behavior Case Reports
Claudio Liguori, Francesca Izzi, Natalia Manfredi, Nicola Biagio Mercuri, Fabio Placidi
Carbamazepine (CBZ) is a first generation anti-seizure drug, considered as first choice therapy in focal epilepsy but associated with cognitive side effects. Lacosamide (LCM) is a third-generation anti-seizure drug approved for treating focal epilepsy. This case series documented the comparable efficacy of LCM and CBZ as first add on treatments in patients affected by uncontrolled focal seizures. LCM showed an increase in EpiTrack scores, which measure cognitive abilities, at follow-up compared to CBZ. This preliminary data may represent the basis for future prospective studies aimed at comparing the long-term cognitive side effects of LCM and CBZ...
2018: Epilepsy & Behavior Case Reports
Su-Ching Hu, Kun-Long Hung, Hui-Ju Chen, Wang-Tso Lee
A 15-year-old boy experienced myoclonic seizures for 3 years. He initially had occasional myoclonus, gradually progressive ataxia, tremors, and psychomotor and speech regression developed. Eventually, he exhibited nearly continuous myoclonus. He received treatment of sodium valproate, levetiracetam, clobazam, and phenobarbital, without efficacy. A ketogenic diet also proved ineffective. Adjunctive therapy with 4 mg/day of perampanel was started and was gradually titrated to 10 mg/day. The remission of myoclonic seizures was achieved within one month...
2018: Epilepsy & Behavior Case Reports
Andy Cheuk-Him Ng, Miljan Tripic, Seyed M Mirsattari
Herein, we describe a case report of anti-NMDA receptor encephalitis characterized by a single generalized tonic-clonic seizure and predominantly psychiatric symptoms, persisting long after EEG abnormalities had resolved. We discuss common presentations of anti-NMDA receptor encephalitis and advocate for the inclusion of this disease entity in the differential diagnosis of patients presenting with one generalized tonic-clonic seizure and prominent psychiatric symptoms.
2018: Epilepsy & Behavior Case Reports
Nikolai Gil D Reyes, Mario B Prado, Christian Wilson R Turalde, Marc Laurence L Fernandez
•In patients presenting with clinical manifestations of encephalitis without clinical or laboratory signs of infection, an autoimmune etiology should be suspected.•Antibodies for various neural antigens may coexist, thus a complete and clinically-guided autoimmune panel must be done in suspected cases of autoimmune encephalitis.•Tumor resection, if applicable, combined with high dose steroids and immunotherapy are effective treatment strategies for autoimmune encephalitis with coexisting antibodies.
2018: Epilepsy & Behavior Case Reports
Patrick Kwan, Scott Mintzer, Antonio Laurenza, Anna Patten, Karen Cartwright
Perampanel, a selective, non-competitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, is approved for adjunctive treatment of focal seizures, with or without secondarily generalized seizures, and for primary generalized tonic-clonic seizures in patients with epilepsy aged ≥ 12 years. Perampanel was recently approved for monotherapy use for focal seizures in the U.S.A. Anti-seizure drug monotherapy may be preferable to polytherapy, which is generally associated with increased toxicity, non-compliance, and cost...
2018: Epilepsy & Behavior Case Reports
Jonas Vanags, Monisha Sachdev, Gerald Grant, Mohamad A Mikati
Two patients at our center experienced florid visual hallucinations following hemispherectomy. The first patient had drug-resistant left hemispheric focal seizures at 20 months of age from a previous stroke. Following functional hemispherectomy at age 3, he experienced frightening hallucinations 1 month post-operatively lasting 3.5 months. Our second patient underwent subtotal hemispherectomy at age 6 for drug-resistant focal seizures from right hemispheric cortical dysplasia. Eighteen months later he developed scary visual hallucinations during which he would shout and throw things...
2018: Epilepsy & Behavior Case Reports
Oscar Mauricio Romero Osorio, Juan Felipe Abaunza Camacho, Diana Sandoval Briceño, Pieralessandro Lasalvia, Daniel Narino Gonzalez
Cardiopulmonary complications associated with epilepsy are generally associated with generalized tonic-clonic seizures, as a consequence of systemic adrenergic discharge and release of inflammatory mediators. We present a case of a 34-year-old woman with a history of Focal epilepsy since adolescence, who presented self-limited pulmonary edema following a focal to bilateral tonic-clonic seizure with subsequent resolution of the symptoms. We also made a brief review of neurogenic pulmonary edema, its proposed pathophysiology, treatment and its relation with sudden unexpected death in epilepsy (SUDEP)...
2018: Epilepsy & Behavior Case Reports
Peraya Piromruen, Chusak Limotai
No abstract text is available yet for this article.
2018: Epilepsy & Behavior Case Reports
Lilit Mnatsakanyan, Sumeet Vadera, Christopher W Ingalls, Jie Zheng, Mona Sazgar, Frank P Hsu, Jack J Lin
Epilepsy surgery is indicated in select patients with drug-resistant focal epilepsy. Seizure freedom or significant reduction of seizure burden without risking new neurological deficits is the expected goal of epilepsy surgery. Typically, when the seizure onset zone overlaps with eloquent cortex, patients are excluded from surgery. We present a patient with drug-resistant frontal lobe epilepsy who underwent successful surgery with resection of Broca's area, primarily involving the pars triangularis (BA 45)...
2018: Epilepsy & Behavior Case Reports
Hidetaka Tamune, Go Taniguchi, Susumu Morita, Yousuke Kumakura, Shinsuke Kondo, Kiyoto Kasai
The association between emotional stimuli and temporal lobe epilepsy (TLE) is largely unknown. Here, we report the case of a depressed, 50-year-old female complaining of episodes of a "spaced out" experience precipitated by emotional stimuli. Psychogenic non-epileptic attacks were suspected. However, video-EEG coupled with emotional stimuli-provoked procedures and MRI findings of amygdala enlargement, led to the diagnosis of left TLE. Accurate diagnosis and explanation improved her subjective depression and seizure frequency...
2018: Epilepsy & Behavior Case Reports
Katie M Kinnear, Nicole M Warner, Anand Gersappe, Michael J Doherty
Objectives: To match responsive neurostimulator (RNS) and polysomnographic data to determine if RNS detections and stimulations correlate with measurements of sleep disordered breathing and continuous glucose measurements (CGM). Materials and methods: In a patient with an RNS with detection/stimulation leads implanted bi-temporally detection-stimulation counts were matched by time with coinciding polysomnogram and CGM data. Results: Temporal dispersion of RNS DSC were independent of measures of sleep apnea, hypopnea or glucose...
2018: Epilepsy & Behavior Case Reports
Carina Büren, Marcel Alexander Kamp, Christopher Munoz-Bendix, Hans-Jakob Steiger, Joachim Windolf, Maxine Dibué-Adjei
A 21-year-old male with an SCN1A mutation died of cerebral herniation 3 h after a seizure occurring during physical activity. Cases of fatal cerebral edema in patients with SCN1A mutations after fever and status epilepticus have been recently reported raising the question whether sodium channel dysfunction may contribute to cerebral edema and thereby contribute to the increased premature mortality in Dravet Syndrome. We report on our patient and discuss whether the combination of hyperthermia and ion channel dysfunction may not only trigger seizures but also a fatal pathophysiological cascade of cerebral edema and herniation leading to cardiorespiratory collapse...
2018: Epilepsy & Behavior Case Reports
Mohamed AlKhaja, Ammar AlKawi, Mahmoud Abu-Ata, Asma Mohammaddin
Numerous autoantibodies are implicated in the pathogenesis of autoimmune epilepsy. In the past decade, many case series reported the association of glutamic acid decarboxylase 65 (GAD 65) antibodies with epilepsy. Conjoint presence of GAD 65 antibodies with antinuclear, anti-thyroid, and anti-parietal cell antibodies has often been demonstrated. However, concomitant elevated levels of GAD 65 and P/Q voltage gated calcium channel (VGCC) antibodies is rare. We report a case of autoimmune epilepsy with conjoint GAD 65 and P/Q VGCC antibodies in the absence of malignancy...
2018: Epilepsy & Behavior Case Reports
Kenchaiah Raghavendra, Ganne Chaitanya, Bhargava Goutham, Anita Mahadevan, Ravindranadh Chowdary Mundlamuri, Rose Dawn Bharath, Mariyappa Narayannan, Malla Bhaskar Rao, Arimappamagan Arivazhagan, Parthasarthy Satishchandra, Sanjib Sinha
Sublobar dysplasia, a rare cortical malformation has been defined in only 8 patients to date. It was identified on the basis of histopathological features and MRI findings. We report a right temporal sublobar dysplasia, with detailed evaluation including neuroimaging, magnetoencephalography and histopathology to further characterize the pathology. Additional pathological features included a deep collateral sulcus in the basal right temporal lobe, thinned out right corticospinal tract, and bilateral asymmetric basal ganglia changes...
2018: Epilepsy & Behavior Case Reports
Albi J Chalissery, Emer Murphy, Gerard Mullins, Peter Widdess-Walsh, Ronan Kilbride, Norman Delanty
•Recurrent catamenial status epilepticus may occur in generalized and focal epilepsy.•Documenting the menstrual cycles and perimenstrual video-EEG help the diagnosis.•Hormonal treatment including menstrual suppressive therapies may be used.
2018: Epilepsy & Behavior Case Reports
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