Cases reported "Seizures, Febrile"

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11/21. Occurrence of a prolonged nonepileptic motor status after a febrile seizure.

    PURPOSE: Febrile seizures are very common events in the pediatric population, and this disorder could be inherited. A previous article on nonepileptic status after a febrile seizure was published by Japanese authors. They described convulsive manifestations after a febrile seizure with an EEG counterpart characterized by delta activity and rhythmic theta discharges. We report two cases of nonepileptic prolonged motor status occurring after a simple febrile seizure, erroneously diagnosed as an epileptic status. methods: An EEG was obtained during the episode in both of the children; for one of them, we performed a video-EEG recording. RESULTS: In both children, this state was characterized by tonic, vibratory posture, and fluctuation of consciousness. The face was not involved, eyes were closed, and the children were not cyanotic. Ictal EEG showed alternating and mixed theta-delta activity. This activity appeared to be rhythmic in some periods. Clinical and EEG features did not change after administration of benzodiazepine. CONCLUSIONS: We believe this uncommon condition to be a nonepileptic phenomenon, occurring after a simple febrile seizure, with favorable prognosis.
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ranking = 1
keywords = status, simple
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12/21. A febrile child with seizure and hemiparesis.

    Febrile seizures are the most common neurological disorders in children and are among the more common symptoms that lead to an emergency department visit. Although most febrile seizures are simple and benign, these seizures can infrequently create a diagnostic dilemma. The diagnosis of cerebral venous thrombosis is challenging to emergency physicians because it can mimic the presentation of many other disorders, including ischemic and hemorrhagic stroke, tumor, and abscess. In addition, the broad variety of signs and symptoms makes the clinical diagnosis difficult. The patients may be presented with signs of increased intracranial pressure or focal neurological deficits. It is an uncommon but potentially dangerous cause of hemiparesis after seizure. Early recognition of this condition and appropriate management may reduce the mortality rate. We present a young child with dural sinus thrombosis who presented with seizures associated with fever and subsequent hemiparesis, and explained a possible mechanism of focal neurological deficit.
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ranking = 0.00078425075132869
keywords = simple
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13/21. Periodic febrile confusion as a presentation of complex partial status epilepticus.

    A 75-year-old woman was evaluated for recurrent episodes of fever she experienced periodically every 4-5 weeks over the last 12 months, lasting 2-3 days each. The fever was associated with continuous complex partial seizures, paralleled the seizure activity and returned to normal after the seizures had ceased. The ictal EEG recordings showed rhythmic bitemporal 3-4 Hz activity; the interictal recordings showed a spike and wave discharge over the right fronto-temporal region. carbamazepine effectively controlled both the seizures and the fever; the latter was presumed to be an inherent manifestation of the seizure activity.
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ranking = 112.12951931449
keywords = status epilepticus, epilepticus, status, complex
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14/21. Prolonged intermittent drooling and oromotor dyspraxia in benign childhood epilepsy with centrotemporal spikes.

    Prolonged isolated sialorrhea of epileptic origin was described by Penfield and Jasper (1954) in a patient with a lesional epilepsy. A child with prolonged but intermittent drooling, lingual dyspraxia, and other clinical and electroencephalographic (EEG) features compatible with benign childhood epilepsy with centrotemporal spikes (BCECS) is described. The fluctuant course of the symptomatology and correlation with the intensity of the paroxysmal discharges on EEG are consistent with an epileptic dysfunction located in the lower rolandic fissure. No lesion was demonstrated by magnetic resonance imaging (MRI). Our case bears analogies with the recently reported status epilepticus of BCECS and the "acquired aphasia-epilepsy syndrome."
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ranking = 28.031541517567
keywords = status epilepticus, epilepticus, status
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15/21. Severe myoclonic epilepsy of infancy.

    Severe myoclonic epilepsy of infancy (SMEI) is a recently identified seizure disorder with a uniformly poor prognosis. No successful therapy has been found for this disorder. Based on the treatment of 7 patients who qualified for the diagnosis in this report, SMEI has a better prognosis than recognized currently. All 7 patients were responding poorly to phenobarbital, phenytoin, or carbamazepine. Six of them responded to valproate. Two patients became seizure-free during valproate monotherapy. A succinimide was required as a second antiepileptic drug in 3 patients to achieve seizure control. Repeated episodes of "febrile status epilepticus" in 2 patients were controlled with lorazepam. Five of 7 patients are doing significantly better than the literature would suggest is possible. Seizure control can be achieved in SMEI with aggressive use of drugs which are beneficial for myoclonic seizures. Traditional drugs for tonic-clonic seizures are of little or no benefit in SMEI.
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ranking = 28.031541517567
keywords = status epilepticus, epilepticus, status
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16/21. Febrile convulsions in an adult as presenting symptom of intracranial dermoid cyst: a case report.

    A 32-year-old man had generalized tonic-clonic epileptic seizures associated with episodes of recurrent high fever for 6 years. Repeated physical examinations including neurological status, EEG and nuclear brain scan were negative. brain CT showed a non-homogeneous parasellar cyst of low density and fat-fluid levels in the lateral ventricles. The diagnosis of intracranial dermoid cyst was confirmed at surgery and histopathologically. Recurrent febrile convulsions and chemical meningitis may be the only clinical manifestations of ruptured dermoid cyst. The CT features of intracranial dermoid cyst are pathognomonic.
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ranking = 0.14263307121391
keywords = status
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17/21. Prolonged apnoea with severe arterial hypoxaemia resulting from complex partial seizures.

    Multi-channel tape-recordings of the EEG, breathing movements, arterial pulsed oxygen saturation and ECG were performed on a four-year-old child with a history of cyanotic episodes. These had started at nine months of age, resulted in cardiopulmonary resuscitation on unnumerable occasions, and were refractory to anti-epileptic medication. During each episode seizure activity appeared first, followed within a few seconds by sinus tachycardia, prolonged absence of inspiratory efforts and severe arterial hypoxaemia. As the seizure activity ended, breathing movements restarted and there was a gradual improvement in oxygenation.
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ranking = 0.0026825953790411
keywords = complex
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18/21. Benign epilepsy of children with complex partial seizures following febrile convulsions.

    Among the partial epilepsies with complex partial seizures (CPS) following febrile convulsions (FC), there is an idiopathic epilepsy with extremely benign outcome, characterized by: 1) no past history suggesting brain insult, no underlying brain lesions, no neurological abnormalities, no mental retardation; 2) a high incidence of a positive family history of FC or benign epilepsy; 3) no past history of prolonged febrile convulsions; 4) EEG spike foci other than anterior temporal ones; 5) CPS easily controlled with full recovery.
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ranking = 0.0033532442238014
keywords = complex
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19/21. Cerebral tuberculosis presenting as complex febrile convulsions.

    Complex febrile convulsions were the initial clinical manifestation of miliary tuberculosis in a 4-year-old immigrant girl. The cerebral lesions were visible only after contrast-enhanced cranial computed tomography (CT) while native CT scan as well as cell count and glucose concentration in the cerebrospinal fluid were normal. mycobacterium tuberculosis was cultured from gastric aspirate and liver biopsy tissue. Treatment with isoniazid and rifampin for 12 months, pyrazinamide for 9 months, and ethambutol for the initial 6 weeks resulted in resolution of the cerebral lesions but a retinal scar after granuloma formation in the right eye caused reduced visus. This case demonstrates the importance of thorough search for tuberculosis even in the absence of overt clinical pulmonary signs especially in high-risk individuals such as immigrants.
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ranking = 0.0026825953790411
keywords = complex
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20/21. Generalized epilepsy with febrile seizures plus. A genetic disorder with heterogeneous clinical phenotypes.

    The clinical and genetic relationships of febrile seizures and the generalized epilepsies are poorly understood. We ascertained a family with genealogical information in 2000 individuals where there was an unusual concentration of individuals with febrile seizures and generalized epilepsy in one part of the pedigree. We first clarified complex consanguineous relationships in earlier generations and then systematically studied the epilepsy phenotypes in affected individuals. In one branch (core family) 25 individuals over four generations were affected. The commonest phenotype, denoted as 'febrile seizures plus' (FS ), comprised childhood onset (median 1 year) of multiple febrile seizures, but unlike the typical febrile convulsion syndrome, attacks with fever continued beyond 6 years, or afebrile seizures occurred. seizures usually ceased by mid childhood (median 11 years). Other phenotypes included FS and absences, FS and myoclonic seizures, FS and atonic seizures, and the most severely affected individual had myoclonic-astatic epilepsy (MAE). The pattern of inheritance was autosomal dominant. The large variation in generalized epilepsy phenotypes was not explained by acquired factors. Analysis of this large family and critical review of the literature led to the concept of a genetic epilepsy syndrome termed generalized epilepsy with febrile seizures plus (GEFS ). GEFS has a spectrum of phenotypes including febrile seizures, FS and the less common MAE. Recognition of GEFS explains the epilepsy phenotypes of previously poorly understood benign childhood generalized epilepsies. In individual patients the inherited nature of GEFS may be overlooked. Molecular genetic study of such large families should allow identification of genes relevant to febrile seizures and generalized epilepsies.
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ranking = 0.00067064884476028
keywords = complex
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