Diana Pizarro , Emilia Toth , Auriana Irannejad , Kristen O. Riley , Zeenat Jaisani , Wolfgang Muhlhofer , Roy Martin , Sandipan Pati
{"title":"Auras localized to the temporal lobe disrupt verbal memory and learning — Causal evidence from direct electrical stimulation of the hippocampus","authors":"Diana Pizarro , Emilia Toth , Auriana Irannejad , Kristen O. Riley , Zeenat Jaisani , Wolfgang Muhlhofer , Roy Martin , Sandipan Pati","doi":"10.1016/j.ebcr.2018.07.006","DOIUrl":"10.1016/j.ebcr.2018.07.006","url":null,"abstract":"<div><p>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. Tasks measuring auditory working memory and psychomotor processing speed were not affected by the stimulation. The study confirms that FAS can impair episodic verbal memory and learning.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 99-101"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36459479","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}
Jonas Vanags , Monisha Sachdev , Gerald Grant , Mohamad A. Mikati
{"title":"Visual hallucinations: A novel complication after hemispherectomy","authors":"Jonas Vanags , Monisha Sachdev , Gerald Grant , Mohamad A. Mikati","doi":"10.1016/j.ebcr.2017.09.005","DOIUrl":"10.1016/j.ebcr.2017.09.005","url":null,"abstract":"<div><p>Two patients at our center experienced florid visual hallucinations following hemispherectomy. The first patient had drug-resistant left hemispheric focal seizures at 20<!--> <!-->months of age from a previous stroke. Following functional hemispherectomy at age 3, he experienced frightening hallucinations 1<!--> <!-->month post-operatively lasting 3.5<!--> <!-->months. Our second patient underwent subtotal hemispherectomy at age 6 for drug-resistant focal seizures from right hemispheric cortical dysplasia. Eighteen<!--> <!-->months later he developed scary visual hallucinations during which he would shout and throw things. Hallucinations recurred for 6<!--> <!-->months. In our experience in these patients, even though symptoms were florid, they were transient and subsided 3–6<!--> <!-->months later.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"9 ","pages":"Pages 51-53"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36041875","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}
Alba González , Dag Aurlien , Kristina H. Haugaa , Erik Taubøll
{"title":"Epilepsy in patients with long QT syndrome type 1: A Norwegian family","authors":"Alba González , Dag Aurlien , Kristina H. Haugaa , Erik Taubøll","doi":"10.1016/j.ebcr.2018.09.006","DOIUrl":"10.1016/j.ebcr.2018.09.006","url":null,"abstract":"<div><p>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 <em>KCNQ1</em> 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.</p><p>Our findings are consistent with the notion that mutations in the <em>KCNQ1</em> gene can cause epilepsy.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 118-121"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36656195","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}
Rajsekar R. Rajaraman , Raman Sankar , Shaun A. Hussain
{"title":"Successful use of pure cannabidiol for the treatment of super-refractory status epilepticus","authors":"Rajsekar R. Rajaraman , Raman Sankar , Shaun A. Hussain","doi":"10.1016/j.ebcr.2018.07.004","DOIUrl":"10.1016/j.ebcr.2018.07.004","url":null,"abstract":"<div><p>We present the case of a child with long-standing, super-refractory status epilepticus (SRSE) who manifested prompt and complete resolution of SRSE upon exposure to pure cannabidiol. SRSE emerged in the context of remote suspected encephalitis with previously well-controlled epilepsy. We discuss the extent to which response may be specifically attributed to cannabidiol, with consideration and discussion of multiple potential drug–drug interactions. Based on this case, we propose that adjunctive cannabidiol be considered in the treatment of SRSE.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 141-144"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36866136","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}
Eduardo Gutiérrez-Maldonado, Claudia Ivette Ledesma-Ramírez, Adriana Cristina Pliego-Carrillo, José Javier Reyes-Lagos
{"title":"Sign and magnitude scaling properties of heart rate fluctuations following vagus nerve stimulation in a patient with drug-resistant epilepsy","authors":"Eduardo Gutiérrez-Maldonado, Claudia Ivette Ledesma-Ramírez, Adriana Cristina Pliego-Carrillo, José Javier Reyes-Lagos","doi":"10.1016/j.ebcr.2018.05.003","DOIUrl":"10.1016/j.ebcr.2018.05.003","url":null,"abstract":"<div><p>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. Novel fractal scaling exponents from HRV analysis were obtained from this patient and from a healthy control subject. Our results indicate that fractal indices of HRV, such as short-term scaling parameters from magnitude and sign analyses seem to be sensitive to the presence or absence of VNS, being confirmed by linear classical methods. This study shows that VNS therapy increases the complexity of cardiac fluctuations in a patient with drug-resistant epilepsy, reflecting an augmented HRV non-linearity and a diminished anticorrelated pattern in heart rate fluctuations. A potential clinical use of these parameters includes the early identification of bradycardia, sudden unexpected death (SUDEP) risk and preoperative VNS approaches. Thus, the scaling and magnitude properties of HRV have potential importance as a non-invasive and easy method for adequate diagnostic/prognostic implications in epilepsy treatment.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 78-81"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36386046","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}
{"title":"Conjoint glutamic acid decarboxylase 65 and P/Q voltage gated calcium channel antibodies in autoimmune epilepsy: A case report","authors":"Mohamed AlKhaja , Ammar AlKawi , Mahmoud Abu-Ata , Asma Mohammaddin","doi":"10.1016/j.ebcr.2017.12.002","DOIUrl":"10.1016/j.ebcr.2017.12.002","url":null,"abstract":"<div><p>Numerous autoantibodies are implicated in the pathogenesis of autoimmune epilepsy. In the past decade, many case series reported the association of glutamic acid decarboxylase 65 (GAD 65) antibodies with epilepsy. Conjoint presence of GAD 65 antibodies with antinuclear, anti-thyroid, and anti-parietal cell antibodies has often been demonstrated. However, concomitant elevated levels of GAD 65 and P/Q voltage gated calcium channel (VGCC) antibodies is rare. We report a case of autoimmune epilepsy with conjoint GAD 65 and P/Q VGCC antibodies in the absence of malignancy. This report highlights a possible role of P/Q VGCC antibodies in the pathogenesis of autoimmune epilepsy.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"9 ","pages":"Pages 26-28"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36041868","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}
Katie M. Kinnear , Nicole M. Warner , Anand Gersappe , Michael J. Doherty
{"title":"Pilot data on responsive epilepsy neurostimulation, measures of sleep apnea and continuous glucose measurements","authors":"Katie M. Kinnear , Nicole M. Warner , Anand Gersappe , Michael J. Doherty","doi":"10.1016/j.ebcr.2017.12.004","DOIUrl":"10.1016/j.ebcr.2017.12.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To match responsive neurostimulator (RNS) and polysomnographic data to determine if RNS detections and stimulations correlate with measurements of sleep disordered breathing and continuous glucose measurements (CGM).</p></div><div><h3>Materials and methods</h3><p>In a patient with an RNS with detection/stimulation leads implanted bi-temporally detection-stimulation counts were matched by time with coinciding polysomnogram and CGM data.</p></div><div><h3>Results</h3><p>Temporal dispersion of RNS DSC were independent of measures of sleep apnea, hypopnea or glucose.</p></div><div><h3>Conclusion</h3><p>Hippocampal nighttime responsive neurostimulation therapies did not appear to worsen measures of normal or abnormal sleep.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"9 ","pages":"Pages 33-36"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36041870","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}
{"title":"Emotional stimuli-provoked seizures potentially misdiagnosed as psychogenic non-epileptic attacks: A case of temporal lobe epilepsy with amygdala enlargement","authors":"Hidetaka Tamune , Go Taniguchi , Susumu Morita , Yousuke Kumakura , Shinsuke Kondo , Kiyoto Kasai","doi":"10.1016/j.ebcr.2017.04.004","DOIUrl":"10.1016/j.ebcr.2017.04.004","url":null,"abstract":"<div><p>The association between emotional stimuli and temporal lobe epilepsy (TLE) is largely unknown. Here, we report the case of a depressed, 50-year-old female complaining of episodes of a “spaced out” experience precipitated by emotional stimuli. Psychogenic non-epileptic attacks were suspected. However, video-EEG coupled with emotional stimuli-provoked procedures and MRI findings of amygdala enlargement, led to the diagnosis of left TLE. Accurate diagnosis and explanation improved her subjective depression and seizure frequency. This case demonstrated that emotional stimuli can provoke seizures in TLE and suggested the involvement of the enlarged amygdala and the modulation of emotion-related neural circuits.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"9 ","pages":"Pages 37-41"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2017.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36041871","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}
William O. Tatum , Tasneem F. Hasan , Erin E. Coonan , Christopher P. Smelick
{"title":"Recurrent seizures from chronic kratom use, an atypical herbal opioid","authors":"William O. Tatum , Tasneem F. Hasan , Erin E. Coonan , Christopher P. Smelick","doi":"10.1016/j.ebcr.2018.04.002","DOIUrl":"10.1016/j.ebcr.2018.04.002","url":null,"abstract":"<div><p>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. Our case suggests Kratom abuse may be associated with structural brain lesions on MRI and symptomatic focal epilepsy.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 18-20"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36359150","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}
Emin Timer , Saeid Charsouei , Nerses Bebek , Betül Baykan , Bilge Bilgiç , Pulat Akın Sabancı , Yavuz Aras , Nail İzgi , Candan Gürses
{"title":"Neurosurgical treatment of nonconvulsive status epilepticus due to focal cortical dysplasia","authors":"Emin Timer , Saeid Charsouei , Nerses Bebek , Betül Baykan , Bilge Bilgiç , Pulat Akın Sabancı , Yavuz Aras , Nail İzgi , Candan Gürses","doi":"10.1016/j.ebcr.2018.03.003","DOIUrl":"10.1016/j.ebcr.2018.03.003","url":null,"abstract":"<div><p>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. Histopathologic analysis of the resected tissue revealed type-IIB FCD. This case illustrates the importance of early surgery to help restore cognitive functions by eliminating the clinical and electrophysiological features of NCSE.</p></div>","PeriodicalId":56365,"journal":{"name":"Epilepsy and Behavior Case Reports","volume":"10 ","pages":"Pages 4-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ebcr.2018.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36326190","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}