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Epilepsy & Behavior Case Reports

Meghna Rajaprakash, Julie Richer, Erick Sell
Duplication of the methyl-CpG-binding protein 2 gene (MECP2) is a rare condition that results in epilepsy in half of the cases. Although this condition has been well characterized in the literature, there is a lack of research on MECP2 duplication-related epilepsy and its management. We present the case of an eleven-year old male with MECP2 duplication and epilepsy, who was resistant to polytherapy. The patient responded well to valproic acid (VPA) initially and upon re-challenge. This case report provides evidence for the use of VPA as an initial monotherapy for treatment of drug-resistant MECP2 duplication-related epilepsy...
2018: Epilepsy & Behavior Case Reports
Shuo Huang, Haifa Al-Abri, Alok Sachdeva, Ayham M Alkhachroum, Stephanie Shatzman, Hans Lüders
We report a case of focal status epilepticus (SE) associated with peri-ictal water drinking (PIWD) behavior in a nine-year-old left-handed boy with epilepsy. We reviewed prior cases of epileptic peri-ictal water drinking. Only one adult patient with status epilepticus and PIWD has been reported previously. This is the first reported case of PIWD SE in a pediatric patient with frontal lobe epilepsy. We found PIWD to have no lateralizing value.
2018: Epilepsy & Behavior Case Reports
Andrew Zillgitt, Abdullah Alshammaa, Muhammad Salim Kahn, Sarah Madani, Salman Zahoor, Ellen L Air
•Complications from standard ATL are uncommon and the use of post-operative corticosteroids may reduce complications.•Following standard ATL, FMSE was present after treatment with corticosteroids that resolved after blood sugar control.•After epilepsy surgery, corticosteroids should be used cautiously in people with comorbid diabetes mellitus.
2018: Epilepsy & Behavior Case Reports
Keith Conti, Steven M Falowski
A 52-year-old female with a longstanding history of drug-resistant epilepsy that included focal impaired awareness seizure presented at end of service of her vagus nerve stimulator (VNS) generator. She had undergone a generator replacement in 2010 without complication. However, her latest replacement was accompanied by multiple bouts of asystole. We discuss the case, possible causes of the asystole, and its relevance to the future of VNS generator replacement and epilepsy treatment.
2018: Epilepsy & Behavior Case Reports
Alba González, Dag Aurlien, Kristina H Haugaa, Erik Taubøll
The congenital long QT syndrome (cLQTS) is an inherited cardiac disorder and is associated with sudden cardiac death. We describe a Norwegian family with mutations within the KCNQ1 gene causing cLQTS type 1 (LQT1) and epilepsy. The index patient had Jervell and Lange-Nielsen-syndrome (JLNS) with deafness and recurrent episodes of cardiac arrhythmia. The mother and the brother have Romano-Ward syndrome (RWS) with recurrent arrhythmias. Whereas the father has focal epilepsy and genetically verified LQT1, the sister has both focal epilepsy and RWS...
2018: Epilepsy & Behavior Case Reports
Anastasie M Dunn-Pirio, Sarah Woodring, Eric Lipp, James E Herndon, Patrick Healy, Mallika Weant, Dina Randazzo, Annick Desjardins, Henry S Friedman, Katherine B Peters
Glioma-associated epilepsy is associated with excessive glutamate signaling. We hypothesized that perampanel, an amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-type glutamate receptor antagonist, would treat glioma-related epilepsy. We conducted a single-arm study of adjunctive perampanel for patients with focal-onset glioma-associated seizures. The most common related adverse events were fatigue and dizziness. Three out of 8 participants had self-reported seizure reduction and an additional 3 reported improved control...
2018: Epilepsy & Behavior Case Reports
Hilde M Braakman, Joke Creemers, Danny M Hilkman, Sylvia Klinkenberg, Suzanne M Koudijs, Mariette Debeij-van Hall, Erwin M Cornips
We report a child with Lennox-Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. EEG recording demonstrated a non-convulsive status epilepticus that was halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor development...
2018: Epilepsy & Behavior Case Reports
Jacob S Bird, Emiy Shah, Paul Shotbolt
People with epilepsy (PWE) often suffer psychiatric symptoms which can impact them more than seizures. Affective and psychotic disorders are well recognized as occurring more frequently in PWE than the general population. Less is known about obsessive-compulsive disorder (OCD) in PWE, despite it being as disabling and distressing. We sought to explore the association between epilepsy and OCD with casereports by identifying ten PWE and concomitant OCD. Demographics, seizure classification, neurological, surgical, psychiatric and psychological treatment as well as quality of life were examined...
2018: Epilepsy & Behavior Case Reports
Susumu Morita, Go Taniguchi, Hidetaka Tamune, Yousuke Kumakura, Shinsuke Kondo, Kiyoto Kasai
Depressive disorders in epilepsy often present characteristic clinical manifestations atypical in primary, endogenous depression. Here, we report a case of a 64-year-old woman with right mesial temporal lobe epilepsy, who complained of bizarre, antipsychotic-refractory cenesthetic hallucinations in her interictal phase, and was hospitalized after a suicide attempt. Detailed clinical observations revealed mood symptoms, which led to the diagnosis of interictal dysphoric disorder comorbid with interictal psychosis...
2018: Epilepsy & Behavior Case Reports
Diana Pizarro, Emilia Toth, Auriana Irannejad, Kristen O Riley, Zeenat Jaisani, Wolfgang Muhlhofer, Roy Martin, Sandipan Pati
Auras (focal aware seizure; FAS) are subjective ictal events with retained consciousness. Epileptiform activities can disrupt cognitive tasks, but studies are limited to seizures with impaired awareness. As a proof of concept, we examined the cognitive effects of direct electrical stimulation to the left hippocampus which induced a habitual FAS in a patient with left mesial temporal lobe epilepsy. During the induced habitual FAS, verbal memory performance declined significantly as compared to pre-stimulation testing...
2018: Epilepsy & Behavior Case Reports
Go Taniguchi, Hitomi Fuse, Yumiko Okamura, Harushi Mori, Shinsuke Kondo, Kiyoto Kasai, Yukitoshi Takahashi, Keiko Tanaka
Focal neuroinflammation is considered one of the hypotheses for the cause of temporal lobe epilepsy (TLE) with amygdala enlargement (AE). Here, we report a case involving an adult female patient with TLE-AE characterized by late-onset seizures and cognitive impairment. Anti- N -methyl-d-aspartate receptor (NMDAR) antibodies were detected in her cerebrospinal fluid. However, administration of appropriate anti-seizure drugs (ASD), without immunotherapy, improved TLE-AE associated with NMDAR antibodies. In the present case, two clinically significant observations were made: 1) anti-NMDAR antibody-mediated autoimmune processes may be associated with TLE-AE, and 2) appropriate administration of ASD alone can improve clinical symptoms in mild cases of autoimmune epilepsy...
2018: Epilepsy & Behavior Case Reports
Vineet Punia, Juan Bulacio, Jorge Gonzalez-Martinez, Ahmed Abdelkader, William Bingaman, Imad Najm, Andrey Stojic
Object: The objective of the study is to investigate and report our experience with extra operative intracranial EEG monitoring for evaluation of epilepsy surgery among elderly (≥ 60 years) patients. Methods: After IRB approval, we searched our prospectively maintained epilepsy surgery database to find patients who underwent eiEEG at the age of 60 years or older. Electronic medical records were reviewed to extract clinical and surgery-related information...
2018: Epilepsy & Behavior Case Reports
Keiko Usui, Kiyohito Terada, Naotaka Usui, Kazumi Matsuda, Akihiko Kondo, Takayasu Tottori, Jun Shinozaki, Takashi Nagamine, Yushi Inoue
This study compared temporal lobe epilepsy (TLE) patients with amygdala lesion (AL) without hippocampal sclerosis (HS) (TLE-AL) with patients with TLE and HS without AL (TLE-HS). Both subtypes of TLE arose from the right hemisphere. The TLE-AL group exhibited a lower Working Memory Index (WMI) on the Wechsler Adult Intelligence Scale, third edition (WAIS-III), indicating that the amygdala in the right hemisphere is involved in memory-related function. [18F]fluorodeoxyglucose positron emission topography (FDG-PET) showed glucose hypometabolism limited to the right uncus for the TLE-AL group...
2018: Epilepsy & Behavior Case Reports
Eduardo Gutiérrez-Maldonado, Claudia Ivette Ledesma-Ramírez, Adriana Cristina Pliego-Carrillo, José Javier Reyes-Lagos
Vagus nerve stimulation (VNS) therapy has been recently incorporated in Latin America as a treatment for drug-resistant epilepsy. In particular, it is known that linear analysis and fractal parameters of heart rate variability (HRV) are able to indirectly measure cardiac autonomic activity. This case report presents a 17-year-old female with drug-resistant epilepsy implanted with a VNS device. In order to explore cardiac autonomic changes due to VNS, linear and fractal HRV indices were calculated in the presence and absence of neurostimulation...
2018: Epilepsy & Behavior Case Reports
Dobrinko Socanski, Nebojsa Jovic, Harald Beneventi, Anita Herigstad
•We report the successful treatment of a boy with hypothalamic tumor, gelastic seizures, drug-resistant epilepsy and ADHD•The use of methylphenidate significantly reduced symptoms of ADHD while seizure frequency remained unchanged.
2018: Epilepsy & Behavior Case Reports
Kwan-Ming Karen Yam, Wing-Kwan Alex Leung, Xian-Lun Zhu, Lai-Wah Eva Fung
•Mesial temporal sclerosis (MTS) is a potential late complication of hematological malignancies.•Seizures are usually drug resistant with MTS yet seizure freedom may be achieved by surgery.•Early evaluation for epilepsy surgery is warranted for drug resistant seizures due to AML.
2018: Epilepsy & Behavior Case Reports
Katie M Kinnear, Nicole M Warner, Alan M Haltiner, Michael J Doherty
Objectives: To investigate if glucose levels influence seizure patterns. Materials and methods: In a patient with RNS/NeuroPace implanted bi-temporally and type 1 diabetes mellitus, seizure event times and onset locations were matched to continuous tissue glucose. Results: Left focal seizure (LFS, n = 22) glucoses averaged 169 mg/dL, while right focal seizure (RFS, n = 23) glucoses averaged 131 mg/dL (p = 0.03). LFS occurred at mean time 17:02 while RFS occurred at 04:23...
2018: Epilepsy & Behavior Case Reports
Joseph R Blunck, Joseph W Newman, Ronald K Fields, John E Croom
Background: A ketogenic diet (KD) may have a role in treating patients in super-refractory status epilepticus (SRSE). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have a risk of ketoacidosis that could facilitate induction of KD. Case summary: A 42-year-old with a history of drug resistant epilepsy developed SRSE requiring several pharmacological interventions during her hospital course including the initiation of KD that failed. SGLT2 inhibitor therapy was initiated in a successful attempt to augment ketone production...
2018: Epilepsy & Behavior Case Reports
Hiroko Kato, Ayataka Fujimoto, Tohru Okanishi, Ryo Sugiura, Kentaro Ijima, Hideo Enoki
Purpose: To identify risk factors for VNS-associated arrhythmia. Methods: A literature review identified 14 papers with 21 patients. We compared patients with VNS associated arrhythmia (arrhythmia group, n = 22) and patients without VNS associated arrhythmia (control group of our VNS implanted patients, n = 29). Results: New onset syncopal events following VNS placement were seen in the arrhythmia group (p < 0.001). Conclusion: Even though arrhythmia could be symptomatic, most cases associated with syncope were treated as new-onset epileptic seizures with adjustment of anti-seizure drugs...
2018: Epilepsy & Behavior Case Reports
William O Tatum, Tasneem F Hasan, Erin E Coonan, Christopher P Smelick
Kratom is an herbal compound that has been used as a recreational drug though is not regulated by the Food and Drug Administration. We report a 19-year-old male with recurrent seizures that developed during daily Kratom abuse as a self-treatment for anxiety. Following recurrent focal impaired awareness seizures in addition to generalized tonic-clonic seizures, he was begun on anti-seizure drugs. Seizures subsided after completing rehabilitation. Brain MRI at 29 months revealed bilaterally symmetric T1-hyperintensity in globus pallidus, subthalamic nuclei, and cerebral peduncles...
2018: Epilepsy & Behavior Case Reports
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