1/17. Electroclinical characteristics of hemimegalencephaly.Presented here are two long-term follow-up patients with hemimegalencephaly. Patient 1 had Ohtahara's syndrome, which evolved into West's syndrome. Patient 2 had localization-related epilepsy, which demonstrated epilepsia partialis continua throughout the clinical course. The patients' interictal electroencephalograms revealed asymmetric suppression-burst patterns sometime during the clinical course: only during early infancy in patient 1 and until the last follow-up (at 30 years of age) in patient 2. Both patients had moderate mental and motor disturbances with persistence of seizures. hemiplegia was progressive during early childhood. Aggravation of hemiplegia might be related to frequent seizures and persistent electroencephalographic abnormalities during early childhood. Although asymmetric suppression-burst patterns are considered characteristic electroencephalographic findings in these cases, the duration of their appearance did not have definite prognostic significance.- - - - - - - - - - ranking = 1keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
2/17. Rasmussen encephalitis in childhood.Six patients admitted to the Department of Pediatric neurology at Hacettepe University Children's Hospital between 1992 and 1997 with a clinical diagnosis of Rasmussen encephalitis received surgical treatment for their intractable epilepsy. MRI, SPECT and WADA tests were performed in patients with an epileptic focus demonstrated on routine or long-term video EEG monitoring. Viral studies using the PCR methodology were performed in cases with histopathological evidence of Rasmussen encephalitis. The ages of these patients ranged between 7 and 16 years, and the mean age at onset of seizures was 7.1 /-2.2 years. In four patients seizures presented as epilepsia partialis continua and were refractory to anticonvulsive drug therapy. In three cases intravenous immunoglobulin therapy yielded temporary and partial improvement in seizure control. The mean presurgical follow-up duration was 2.04 1.74 years, and early surgical intervention for epilepsy was performed in one case. The surgical approach selected for the treatment of epilepsy was resective surgery with electrocorticography. The mean postoperative follow-up duration was 32.3 17.2 months. seizures were fully controlled in one patient, in whom surgery was performed 3 months after the seizures first started. Early surgical intervention may provide histopathological evidence for diagnosis as well as effective seizure control.- - - - - - - - - - ranking = 1keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
3/17. Potential hepatotoxicity of lamotrigine.Lamotrigine is a new antiepileptic drug that is effective for a broad range of seizures in adults and children. Three children with seizures of different causes who were treated with lamotrigine and developed reversible hepatotoxicity are reported. In one child, this therapy led to relatively severe hepatic failure that required and responded to aggressive therapy. Unlike most of the previously reported six patients with similar severe hepatic involvement, this patient's liver function and blood hepatic enzymes became normal. All three patients were on multiple drugs, and two were in epilepsia partialis continua secondary to encephalitis. Two of the patients had relatively rapid medication titration schedules. The close time relationship between the initiation of the lamotrigine therapy and the reversal of the liver abnormalities with lamotrigine discontinuation argues against a cause other than the lamotrigine; however, because of the complexity of the reported cases, the causality remains an assumption. review of the literature revealed six other previously reported patients (five adults and one child) who had hepatotoxicity during lamotrigine therapy, with or without associated multisystem failure, and similar patient profiles. Lamotrigine is generally a safe and effective medication; however, it should be used with caution in patients on polytherapy and in those with complicated acute systemic and central nervous system conditions, such as fever, status epilepticus, epilepsia partialis, and encephalitis.- - - - - - - - - - ranking = 2keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
4/17. Suppression-burst patterns in intractable epilepsy with focal cortical dysplasia.We report on a patient with early-onset spasms in series and partial seizures associated with focal cortical dysplasia whose EEGs showed suppression-burst patterns during early infancy. These electroclinical characteristics suggested a diagnosis of Ohtahara syndrome, but the EEG findings were atypical because of the lack of suppression-burst patterns during wakefulness. In addition, the patient did not have severe psychomotor retardation. With high-dose pyridoxal phosphate therapy, seizures were suppressed and suppression-burst patterns disappeared at 2 months of age. Focal motor seizures recurred later and they often evolved into epilepsia partialis continua. patients with early-onset intractable seizures associated with suppression-burst patterns on EEGs have several different etiologies, and these patients should be categorized according to their etiology in addition to their syndromic diagnosis.- - - - - - - - - - ranking = 1keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
5/17. Worster-Drought and congenital perisylvian syndromes-a continuum?A 5-year-old female was evaluated because of severe speech and expressive language delay. On examination, she could hardly speak and communicated through gestures. She manifested severe dysarthria and difficulty in protruding and moving her tongue laterally. She lacked coordination of the swallowing process, with drooling and an increased mental reflex. Her cognitive development was normal, and no associated neurologic dysfunction of the limbs was noted. On follow-up, the child experienced two episodes of seizures at 6 years of age. magnetic resonance imaging of the brain demonstrated perisylvian and frontal polymicrogyria. Clinical and radiologic findings demonstrated a similarity and continuum between congenital suprabulbar paresis (Worster-Drought syndrome) and perisylvian syndrome.- - - - - - - - - - ranking = 0.12896582428157keywords = continuum (Clic here for more details about this article) |
6/17. DRESS syndrome associated with carbamazepine and phenytoin.Drug Rash with eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs. Its clinical manifestations include diffuse maculopapular rash, exfoliative dermatitis, facial edema, lymphadenopathy, fever, multivisceral involvement and it is associated with a high mortality rate. We report a 62-year-old patient suffering from epilepsia presenting erythroderma following carbamazepine intake. blood tests revealed eosinophilia, leukocytosis, elevated liver enzymes and high levels of Eosinophil Cationic Protein (ECP). We applied systemic steroids and anticonvulsant therapy was switched to phenytoin, which had been taken previously without adverse reactions. The skin eruptions persisted and the patient developed fever. Anticonvulsant medication was discontinued and skin eruptions finally resolved under steroid application. This case report demonstrates that cross reactivity between carbamazepine and phenytoin may not only lead to the development but also to the worsening of DRESS syndrome. ECP blood levels may represent a sufficient parameter to monitor the development of DRESS syndrome.- - - - - - - - - - ranking = 0.26186733045696keywords = epilepsia (Clic here for more details about this article) |
7/17. Failure of Implanon contraception in a patient taking carbamazepin for epilepsia.Until now, no pregnancies have been reported in association with the implantable hormonal contraceptive Implanon (Organon, Roseland, NJ, USA), resulting in a pearl index of 0. We present a 24-year-old patient who conceived despite the correct application of Implanon for one and a half year. The patient was concurrently taking carbamazepin for epilepsia. Special care should be taken to patients demanding hormonal contraceptives while taking carbamezepin. Even Implanon seems to possibly fail in this combination.- - - - - - - - - - ranking = 1.3093366522848keywords = epilepsia (Clic here for more details about this article) |
8/17. epilepsia partialis continua in multiple sclerosis.epilepsia partialis continua (EPC) in multiple sclerosis is extremely rare. We report a case of a patient with clinically definite multiple sclerosis who developed EPC. magnetic resonance imaging (MRI) depicted high signal in subcortical white matter and basal ganglia. A combination of lesions may be important in the generation of EPC.- - - - - - - - - - ranking = 0.62644963393065keywords = partialis (Clic here for more details about this article) |
9/17. Neurophysiological follow-up in a case of chronic progressive epilepsia partialis continua of childhood.We report the waking and sleeping polygraphic and evoked potential data recorded during the follow-up of a child with chronic progressive epilepsia partialis continua of childhood (Bancaud's type II). The findings that emerged from these investigations coupled with the clinical pattern enabled us to delineate the course of this rare condition and provided clues for a tentative interpretation of the pathogenesis of the repetitive myoclonic jerks typical of epilepsia partialis continua, on which there is as yet no consensus. In our case involvement of cortico-subcortical systems seems probable.- - - - - - - - - - ranking = 6keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
10/17. scoliosis due to epilepsia partialis continua.A case is reported of scoliosis in a boy with epilepsia partialis continua, an unusual disorder with virtually constant episodes of seizures of only part of the body. The scoliosis appeared to be due to the seizure disorder. The epilepsy seriously inhibited conventional scoliosis management. The patient's scoliosis problem was finally solved by salvage surgery and intensive seizure medication supervision. scoliosis management in complex seizure disorders presents special and unusual problems.- - - - - - - - - - ranking = 5keywords = epilepsia partialis, epilepsia, partialis (Clic here for more details about this article) |
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