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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
Daiki Uchida, Ayataka Fujimoto, Tomohiro Yamazoe, Takamichi Yamamoto, Hideo Enoki
A relationship between seizures and intracranial pressure (ICP) has been proposed, but not clearly identified. Whether changes in ICP can evoke seizures remains controversial. We report the case of a 23-year-old man who had undergone shunt surgery in childhood and later presented with focal impaired awareness seizures and behavior arrest. Seizures were uncontrolled despite 3 years of pharmacotherapy, but suddenly stopped after shunt removal. Our case supports the hypothesis that drug-resistant epilepsy can be influenced by changes in ICP...
2018: Epilepsy & Behavior Case Reports
Adam S Vesole, Yasunori Nagahama, Mark A Granner, Matthew A Howard, Hiroto Kawasaki, Brian J Dlouhy
Introduction: Drug-resistant epilepsy (DRE) occurs in 20-30% of all patients who develop epilepsy and can occur from diverse causes. Cyclosporine-A (CSA) is an immunosuppressive drug utilized to prevent graft-versus-host disease (GvHD) in transplant patients and is known to cause neurotoxicity, including seizures. In some cases, however, patients can develop DRE. Only a limited number of cases have been reported in which DRE has developed after CSA exposure - all in children. Here we present a rare case of an adult developing DRE after post-transplant CSA neurotoxicity...
2018: Epilepsy & Behavior Case Reports
Hussein Algahtani, Bader Shirah, Raghad Algahtani
Lacosamide is one of the third-generation antiseizure drugs that block voltage-gated sodium channels by enhancing slow inactivation. The most common adverse effects of lacosamide include dizziness, headache, nausea, vomiting, diplopia, fatigue, and sedation. Less common side effects include memory impairment, weight gain, rash, and atrioventricular block. In this article, we describe a patient with Lennox-Gastaut syndrome who developed excessive laughing as a rare side effect of lacosamide with complete resolution after discontinuation of the medication...
2018: Epilepsy & Behavior Case Reports
Emin Timer, Saeid Charsouei, Nerses Bebek, Betül Baykan, Bilge Bilgiç, Pulat Akın Sabancı, Yavuz Aras, Nail İzgi, Candan Gürses
We present a rare case of focal cortical dysplasia (FCD) and nonconvulsive status epilepticus (NCSE) treated successfully with early surgical intervention. Our case is a 9-year-old boy whose seizures, characterized by short episodes of loss of consciousness, appeared at the age of 7, and he showed progressive cognitive decline in the following years. NCSE was diagnosed, and his MRI revealed FCD in the left frontal region which was the same side as his EEG abnormality. Following lesionectomy, his NCSE disappeared and cognitive functions improved...
2018: 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
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