Epilepsy and Behavior Case Reports最新文献

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Impairment of consciousness induced by bilateral electrical stimulation of the frontal convexity 双侧额凸电刺激引起的意识损伤
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.09.006
Imran H. Quraishi , Christopher F. Benjamin , Dennis D. Spencer , Hal Blumenfeld , Rafeed Alkawadri
{"title":"Impairment of consciousness induced by bilateral electrical stimulation of the frontal convexity","authors":"Imran H. Quraishi ,&nbsp;Christopher F. Benjamin ,&nbsp;Dennis D. Spencer ,&nbsp;Hal Blumenfeld ,&nbsp;Rafeed Alkawadri","doi":"10.1016/j.ebcr.2017.09.006","DOIUrl":"10.1016/j.ebcr.2017.09.006","url":null,"abstract":"<div><p>We report a case of impairment of consciousness (IOC) induced by electrical cortical stimulation (ECS) of homologous regions within the lateral frontal convexities in a patient with medically intractable epilepsy. The patient had mixed features of idiopathic generalized and focal epilepsy. On intracranial EEG recording, interictal and ictal discharges showed a high degree of synchrony across widespread bilateral fronto-parietal areas. We identified regions in the lateral frontal lobes that reliably and produced loss of consciousness by ECS. This was accompanied by evoked EEG activity of admixed frequencies over the fronto-parietal, mesial frontal and temporal regions during stimulation and was not associated with after-discharges. Symptoms were immediately reversible upon cessation of stimulation. This finding suggests that focal cortical stimulation can disrupt widespread networks that underlie consciousness. Individuals with high degrees of speculated thalamo-frontal cortical connectivity might be more susceptible to this effect, and the findings highlight the importance of standardizing the testing of level of consciousness during mapping sessions.</p><p>Although consciousness is commonly impaired in epileptic seizures, limited literature is available on loss of consciousness induced by electrical cortical stimulation (ECS) in humans undergoing intracranial EEG evaluations for localization of epileptic focus. One theory advocates the presence of consciousness ‘switch’ in subcortical structures. While this model is novel and simplistic, it has its inherent limitations. In this case study, we propose an alternative approach on the entity and discuss the complex circuits underlying it and correlate that with the electrophysiological findings and the pathophysiology of the phenotype of the disease and discuss potential causes for rarity of reports on the subject.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35223095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Functional hemispherotomy in Rasmussen syndrome in the absence of classic MRI findings 在没有典型MRI表现的情况下,Rasmussen综合征的功能性半球切除术
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2016.11.003
Yasunori Nagahama , Charuta Joshi , Brian Dlouhy , Angela Y. Wu , Taylor J. Abel , Gary Baumbach , Hiroto Kawasaki
{"title":"Functional hemispherotomy in Rasmussen syndrome in the absence of classic MRI findings","authors":"Yasunori Nagahama ,&nbsp;Charuta Joshi ,&nbsp;Brian Dlouhy ,&nbsp;Angela Y. Wu ,&nbsp;Taylor J. Abel ,&nbsp;Gary Baumbach ,&nbsp;Hiroto Kawasaki","doi":"10.1016/j.ebcr.2016.11.003","DOIUrl":"10.1016/j.ebcr.2016.11.003","url":null,"abstract":"<div><p>A 7-year-old previously healthy girl presented with a left-sided focal seizure without impaired consciousness and subsequently developed epilepsia partialis continua. Initial MRI was normal, and the subsequent images only showed a focal T2/FLAIR hyperintense area without cortical atrophy. She was diagnosed with Rasmussen syndrome by pathology and promptly treated with functional hemispherotomy. Rasmussen syndrome is a rare progressive neurological disorder, the only definitive cure for which is hemispheric disconnection. The disease presents a management dilemma, especially early in disease course without characteristic neuroimaging features. A high index of suspicion, multidisciplinary approach, and clear timely communication with the family are critical.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"7 ","pages":"Pages 24-27"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2016.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34766102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient 半巨脑畸形患者功能性半球切开术和脑室-腹膜分流器放置后分流器过引流的延迟诊断
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2016.12.003
Yasunori Nagahama , David Peters , Sho Kumonda , Adam Vesole , Charuta Joshi , Brian J. Dlouhy , Hiroto Kawasaki
{"title":"Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient","authors":"Yasunori Nagahama ,&nbsp;David Peters ,&nbsp;Sho Kumonda ,&nbsp;Adam Vesole ,&nbsp;Charuta Joshi ,&nbsp;Brian J. Dlouhy ,&nbsp;Hiroto Kawasaki","doi":"10.1016/j.ebcr.2016.12.003","DOIUrl":"10.1016/j.ebcr.2016.12.003","url":null,"abstract":"<div><p>Shunt overdrainage represents a nebulous condition of variable clinical and imaging presentations, where the diagnosis is primarily clinical. The condition presents a diagnostic challenge particularly in patients with cognitive impairment and developmental delays. Here we present a 3-year-old boy with drug-resistant focal onset seizures due to hemimegalencephaly who previously underwent functional hemispherotomy followed by ventriculoperitoneal shunt placement for postoperative hydrocephalus. The subsequent clinical course was complicated by delayed diagnosis of shunt overdrainage in the absence of significant image findings. Maintaining a high index of suspicion for the possibility of shunt overdrainage is critical even in the face of unremarkable imaging findings.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"7 ","pages":"Pages 34-36"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2016.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34861151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lamotrigine-related pseudolymphoma presenting as cervical lymphadenopathy 拉莫三嗪相关的假性淋巴瘤表现为宫颈淋巴结病
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2016.12.004
Eoin Mulroy, Elizabeth Walker
{"title":"Lamotrigine-related pseudolymphoma presenting as cervical lymphadenopathy","authors":"Eoin Mulroy,&nbsp;Elizabeth Walker","doi":"10.1016/j.ebcr.2016.12.004","DOIUrl":"10.1016/j.ebcr.2016.12.004","url":null,"abstract":"<div><p>Immune-mediated drug reactions are a potentially life-threatening complication of antiseizure medications. Drug hypersensitivity syndrome (DHS) is the best recognised of these, presenting with fever, eosinophilia, rash and internal organ involvement. Isolated lymphadenopathy is a less recognized immune-mediated reaction to antiseizure drugs such as lamotrigine. We describe the case of a 24-year-old woman who developed lamotrigine-related bilateral cervical lymphadenopathy (pseudolymphoma) fifteen months following therapy initiation. This is the second such case reported in the medical literature.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"7 ","pages":"Pages 40-41"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2016.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34861154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Successful surgical management of New Onset Refractory Status Epilepticus (NORSE) presenting with gelastic seizures in a 3 year old girl 成功的手术治疗新发难治性癫痫持续状态(NORSE)表现为弹性癫痫发作的3岁女孩
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.05.002
Ahmad Marashly , Sean Lew , Jennifer Koop
{"title":"Successful surgical management of New Onset Refractory Status Epilepticus (NORSE) presenting with gelastic seizures in a 3 year old girl","authors":"Ahmad Marashly ,&nbsp;Sean Lew ,&nbsp;Jennifer Koop","doi":"10.1016/j.ebcr.2017.05.002","DOIUrl":"10.1016/j.ebcr.2017.05.002","url":null,"abstract":"<div><p>Gelastic seizures (GS) are typically associated with hypothalamic hamartomas and present during childhood. However it is now known that GS can be found in focal epilepsies arising from other regions in the brain, including mesial and neocortical frontal, temporal and parietal regions.</p><p>GS have rarely been described as the presenting manifestation of New Onset Refractory Status Epilepticus (NORSE). In this article we describe a previously healthy 3-year-old who presented with an explosive onset of GS that were refractory to multiple anti-seizure medications. These seizures arose from the right frontal region. An extensive metabolic and immunological evaluation was negative. Her brain magnetic resonance imaging (MRI) was negative, however the Positron Emission Tomography (PET) scan showed a hypermetabolic region in the right frontal inferior gyrus.</p><p>She underwent a depth electrode evaluation that revealed a widespread irritative zone involving the PET “lesion” as well as mesial and neocortical regions in the right frontal lobe. The seizure onset zone was widespread and non-localizable. However the GS were associated with a clear ictal epileptiform discharge on invasive EEG arising from the depth of the superior frontal gyrus, which was not overlapping with the PET hypermetabolic region. She underwent a right frontal lobectomy sparing the primary motor region in the pre-central gyrus. She has remained seizure free for 15<!--> <!-->months since. The pathological analysis showed focal cortical dysplasia type II in the region of the PET scan hypermetabolism. This case expands the clinical spectrum of GS to include cases of NORSE. Additionally the case highlights the role of resective surgery in GS presenting as NORSE and the potentially excellent outcome that can be achieved by early intervention.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 18-26"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35183369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Desensitization of stimulation-induced weight loss: A secondary finding in a patient with vagal nerve stimulator for drug-resistant epilepsy 刺激引起的体重减轻的脱敏:迷走神经刺激治疗耐药癫痫患者的次要发现
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.07.001
Fawad A. Khan , Mugilan Poongkunran , Bonnie Buratto
{"title":"Desensitization of stimulation-induced weight loss: A secondary finding in a patient with vagal nerve stimulator for drug-resistant epilepsy","authors":"Fawad A. Khan ,&nbsp;Mugilan Poongkunran ,&nbsp;Bonnie Buratto","doi":"10.1016/j.ebcr.2017.07.001","DOIUrl":"10.1016/j.ebcr.2017.07.001","url":null,"abstract":"","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 51-54"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35380514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Efficacy of perampanel in a patient with epilepsia partialis continua perampanel治疗持续性部分癫痫的疗效
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.09.004
H. Argente-Escrig, A. Gómez-Ibáñez, V. Villanueva
{"title":"Efficacy of perampanel in a patient with epilepsia partialis continua","authors":"H. Argente-Escrig,&nbsp;A. Gómez-Ibáñez,&nbsp;V. Villanueva","doi":"10.1016/j.ebcr.2017.09.004","DOIUrl":"10.1016/j.ebcr.2017.09.004","url":null,"abstract":"<div><p>Perampanel is the first-in-class selective and noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist. It is authorized in the U.S. and Europe as an add-on antiepileptic drug for partial-onset seizures, and for primary generalized tonic–clonic seizures. Single reports have also indicated a potential efficacy for myoclonic jerks. Here, we report a patient whose drug-resistant epilepsia partialis continua completely resolved after adding perampanel. She has remained seizure-free in an eighteen-month follow-up period. Epilepsia partialis continua reemerged transiently after perampanel was temporarily discontinued, with no recurrence after its reintroduction. Therefore, this effect was reproducible, and suggests that it might be worth trying perampanel in similar settings.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 105-107"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35542289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Dyke–Davidoff–Masson syndrome in a Nigerian 尼日利亚人的Dyke-Davidoff-Masson综合症
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2016.09.003
Philip B. Adebayo , Amnat Bakare , Modupe M. Bello , Opeyemi D. Olaewe , Kolawole W. Wahab
{"title":"Dyke–Davidoff–Masson syndrome in a Nigerian","authors":"Philip B. Adebayo ,&nbsp;Amnat Bakare ,&nbsp;Modupe M. Bello ,&nbsp;Opeyemi D. Olaewe ,&nbsp;Kolawole W. Wahab","doi":"10.1016/j.ebcr.2016.09.003","DOIUrl":"10.1016/j.ebcr.2016.09.003","url":null,"abstract":"<div><p>Dyke–Davidoff–Masson syndrome (DDMS) is a rare, but important cause of drug-resistant seizures. Dyke–Davidoff–Masson syndrome is a constellation of clinical features that consists of hemiparesis, seizure, facial asymmetry, and intellectual disability with distinct neuroimaging features. A 27-year-old lady presented to us with drug-resistant epilepsy, hemiparesis, and intellectual disability that necessitated her withdrawal from school. Her brain magnetic resonance imaging (MRI) showed cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses consistent with DDMS. We discuss the diagnostic and therapeutic implications of DDMS and advocate early referral and evaluation of people with epilepsy in sub-Saharan African settings.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"7 ","pages":"Pages 10-12"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2016.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76857819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Six adult patients with septo-optic dysplasia and drug-resistant epilepsy: Clinical findings and course 成人视隔发育不良伴耐药癫痫6例:临床表现及病程
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.04.001
Mashael AlKhateeb , Richard McLachlan , Jorge Burneo , David Diosy , Seyed Mirsattari
{"title":"Six adult patients with septo-optic dysplasia and drug-resistant epilepsy: Clinical findings and course","authors":"Mashael AlKhateeb ,&nbsp;Richard McLachlan ,&nbsp;Jorge Burneo ,&nbsp;David Diosy ,&nbsp;Seyed Mirsattari","doi":"10.1016/j.ebcr.2017.04.001","DOIUrl":"10.1016/j.ebcr.2017.04.001","url":null,"abstract":"<div><p>Septo-optic dysplasia (SOD) is a rare disorder associated with optic nerve hypoplasia, pituitary abnormalities and agenesis/dysgenesis of midline brain structures including the septum pellucidum and corpus callosum. Though sometimes associated with drug-resistant epilepsy, this association has not been well studied. We report six SOD patients with associated malformation of cortical development (MCD) and drug-resistant epilepsy who underwent video-EEG telemetry at our centre between 1998 and 2016 for drug-resistant epilepsy. ‬Three then underwent surgery; right temporal neocortical resection, right functional hemispherectomy and placement of a vagus nerve stimulator. Clinical findings and the patients' ultimate courses are discussed.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 73-84"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35629894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Efficacy of perampanel for controlling seizures and improving neurological dysfunction in a patient with dentatorubral-pallidoluysian atrophy (DRPLA) perampanel对齿状网膜-苍白球萎缩症(DRPLA)患者控制癫痫发作及改善神经功能障碍的疗效
Epilepsy and Behavior Case Reports Pub Date : 2017-01-01 DOI: 10.1016/j.ebcr.2017.05.004
Hideaki Shiraishi, Kiyoshi Egawa, Tomoshiro Ito, Osamu Kawano, Naoko Asahina, Shinobu Kohsaka
{"title":"Efficacy of perampanel for controlling seizures and improving neurological dysfunction in a patient with dentatorubral-pallidoluysian atrophy (DRPLA)","authors":"Hideaki Shiraishi,&nbsp;Kiyoshi Egawa,&nbsp;Tomoshiro Ito,&nbsp;Osamu Kawano,&nbsp;Naoko Asahina,&nbsp;Shinobu Kohsaka","doi":"10.1016/j.ebcr.2017.05.004","DOIUrl":"10.1016/j.ebcr.2017.05.004","url":null,"abstract":"<div><p>We administered perampanel (PER) to a bedridden 13-year-old male patient with dentatorubral-pallidoluysian atrophy (DRPLA). The DRPLA diagnosis was based on the presence of a CAG trinucleotide repeat in the <em>ATN1</em> gene. The patient experienced continuous myoclonic seizures and weekly generalized tonic–clonic seizures (GTCs). PER stopped the patient's myoclonic seizures and reduced the GTCs to fragmented clonic seizures. The patient recovered his intellectual abilities and began to walk again with assistance. We suggest that PER be considered as one of the key drugs used to treat patients with DRPLA.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"8 ","pages":"Pages 44-46"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35458618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 25
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