Examinations and investigations
In the first patient, the neurological examination was unremarkable. A previous computed tomography scan and EEG were reported as normal. The patient had a magnetic resonance imaging MRI scan, which was also normal. Video-EEG monitoring demonstrated generalized spike-wave discharges interictally as well as in association with her clinical events. In the second patient, the neurological examination was also unremarkable. MRI showed non-specific white matter changes consistent with small vessel...
Examination and investigations Epc
Neurological examination revealed a hypotrophy of the right arm and leg and a mild right-sided central hemiparesis. Cranial computed tomography CT scanning showed a left frontoparietal hypodense region suggestive of infarction and ipsilateral hemispheric atrophy Fig. 38.1 . These findings were confirmed on magnetic resonance imaging. HMPAO Figure 38.1 CT scan demonstrating a left-sided porencephalic lesion and ipsilateral hemispheric hypotrophy. Figure 38.1 CT scan demonstrating a left-sided...
References Fir
1. M ller JC, Hamer HM, Oertel WH, Rosenow F. Late-onset myoclonic epilepsy in Down's syndrome LOMEDS . Seizure 2001 10 303-6. 2. Veall RM. The prevalence of epilepsy among mongols related to age. J Ment Deficiency Res 1974 18 99-106. 3. Tangye SR. The EEG and incidence of epilepsy in Down's syndrome. J Ment Deficiency Res 1979 23 17-24. 4. McVicker RW, Shanks OE, McClelland RJ. Prevalence and associated features of epilepsy in adults with Down's syndrome. Br J Psychiatry 1994 164 528-32. 5....
Examination and Jbt
and symmetric deep tendon reflexes, were unremarkable. The observed left shoulder twitching caused his proximal arm to move in an irregular manner. There was no clonic twitching in the proximal or distal arm or hand. The left shoulder twitching ceased when he was asleep or distracted. The twitching increased if he was asked to move his left arm voluntarily. The intensity of the twitching was variable. Suspecting that the events might be non-epileptic, the neurology house officer applied a...
IV Unforeseen complications and problems275
70 A 35-year-old man with poor surgical outcome after 276 temporal lobe surgery 71 When more is less 279 Carl Bazil 72 Change of antiepileptic drug treatment for fear of side effects 283 in a 45-year-old seizure-free patient 73 Personality and mood changes in a teenager 286 Ahmad Beydoun, Ekrem Kutluay and Erasmo Passaro 74 Monitoring patients may be more important than their 291 laboratory tests 75 Depression in a student with juvenile myoclonic epilepsy 296 Enrique J Carrazana 76 Osteomalacia...
References Rud
1. Towne AR, Waterhouse EJ. Rational diagnosis of subtle and non-convulsive status epilepticus. In Schmidt D, Schachter SC, eds. Epilepsy problem solving in clinical practice. London Martin Dunitz 2000 79 93. 2. DeLorenzo RJ, Hauser WA, Towne AR, et al. A prospective population-based epidemiologic study of status epilepticus in Richmond Virginia. Neurology 1996 46 1029-35. 3. Krumholz A, Sung GY, Fisher RS, Barry E, Bergey GK, Grattan LM. Complex partial status epilepticus accompanied by...
History Owz
A 32-year-old medically retired civil servant was referred to our clinic by his general practitioner. He had a history of epilepsy from the age of 16 years, and 3 years earlier, on referral to a university hospital, he had been correctly diagnosed with frontal lobe epilepsy. Neuroimaging studies had shown right frontal pathology. Therapy with topiramate had been instituted, which led to complete cessation of seizures. However, over the 18-month period between then and his consultation with us,...
References Ixy
1. Echenne B, Cheminal R, Rivier F, et al. Epileptic electroencephalographs abnormalities and developmental dysphasias a study of 32 patients. Brain Dev 1992 14 216-25. 2. Touchman R, Rapin I. Regression in pervasive developmental disorders seizures and EEG correlates. Pediatrics 1997 99 560-6. 3. Roulet-Perez E, Davidiff V, Despland PA, Deonna T. Mental and behavioural deterioration of children with epilepsy and CWCS acquired epileptic frontal syndrome. Dev Med Child Neurol 1993 35 661-74. 4....
Commentary Orv
This case illustrates some important points pertinent to the diagnosis and management of CPSE. As in this patient, 30 50 of patients with CPSE have a history of seizures before developing CPSE.1 In those adult patients who develop CPSE without an antecedent history, CPSE occurs most commonly in association with symptomatic neurological disease such as herpes simplex encephalitis or cerebral infarction. In patients with a history of epilepsy, precipitating factors include recent infection and...