Unusual atypical language lateralization
Publication date: Available online 9 March 2016 Source:Epilepsy & Behavior Case Reports Author(s): Muhammad T. Khan, Roger Oghlakian, Mohamad Z. Koubeissi Determining the language-dominant hemisphere is essential for planning epilepsy surgery. A 60 year-old right-handed woman with epilepsy since age 16, failed a partial right anterior lobectomy at age 21. Later, a brain MRI found extensive right-sided cortical dysplasia and periventricular heterotopia. Subsequently, prolonged video-EEG monitoring localized her seizures to the right temporoparietal region. Functional MRI was inconclusive in lateralizing he...
Source: Epilepsy and Behavior Case Reports - March 9, 2016 Category: Neurology Source Type: research
Challenges in identifying Lennox–Gastaut syndrome in adults: A case series illustrating its changing nature
We present 5 cases that illustrate changes in LGS features over time. Cases 1 and 2 were diagnosed by age 8 with intractable seizures, developmental delay, and abnormal EEGs with 1.5–2Hz SSW discharges. However, seizure type and frequency changed over time for both patients, and the incidence of SSW discharges decreased. Cases 3, 4, and 5 were diagnosed with LGS as adults based on current and past features and symptoms, including treatment-resistant seizures, cognitive and motor impairment, and abnormal EEG findings. While incomplete, their records indicate that an earlier LGS diagnosis may have been missed or lost to hi...
Source: Epilepsy and Behavior Case Reports - March 6, 2016 Category: Neurology Source Type: research
Potential brain language reorganization in a boy with refractory epilepsy; an fNIRS–EEG and fMRI comparison
In this study, we compared functional near infrared spectroscopy (fNIRS) results obtained while the participant performed expressive and receptive language tasks with those obtained using functional magnetic resonance imaging (fMRI). This case study illustrates the potential for NIRS to contribute favorably to the localization of language functions in children with epilepsy and cognitive or behavioral problems and its potential advantages over fMRI in presurgical assessment. Moreover, it suggests that fNIRS is sensitive in localizing an atypical language network or potential brain reorganization related to epilepsy in youn...
Source: Epilepsy and Behavior Case Reports - March 6, 2016 Category: Neurology Source Type: research
Epilepsy with myoclonic–atonic seizures (Doose syndrome): When video-EEG polygraphy holds the key to syndrome diagnosis
We report a child who presented with reflex myoclonus at the age of 9months and was initially diagnosed with myoclonic epilepsy in infancy. After 9years of medically resistant myoclonic seizures, extensive investigations, and emerging learning difficulties, she was referred for video-telemetry to characterize her seizures in an attempt to make a syndromic diagnosis. A three-day video-telemetry assessment was performed to document seizures. Neck and deltoid EMG channels were applied from the onset of the recording. Frequent generalized bursts of 3- to 5-Hz spike/polyspike and slow wave discharges, associated with clinical m...
Source: Epilepsy and Behavior Case Reports - February 25, 2016 Category: Neurology Source Type: research
Microsurgical endoscopy-assisted anterior corpus callosotomy for drug-resistant epilepsy in an adult unresponsive to vagus nerve stimulation
We present the case of a 21-year-old female with medically refractory drop attacks that began at the age of 8years, which resulted in the patient being progressively unresponsive to vagus nerve stimulation implanted at the age of 14years. Corpus callosotomy was recommended to reduce the number of drop attacks. However, the patient had only mild cognitive impairments and no neurological deficits. For this reason, we were forced to plan a surgical approach able to maximize the disconnection for good seizure control while, at the same time, minimizing sequelae from disconnection syndromes and neurosurgical complications becau...
Source: Epilepsy and Behavior Case Reports - February 19, 2016 Category: Neurology Source Type: research
Stereotactic laser ablation of the splenium for intractable epilepsy
We report on the utilization of laser ablation of the splenium in this patient to achieve full corpus callosotomy. Adequate ablation of the splenial remnant was confirmed by postoperative MRI imaging, and at four-month follow-up, the patient's seizure frequency had dropped more than 50%. This is the first reported instance of laser ablation of the splenium to achieve full corpus callosotomy following a previous unsuccessful anterior callosotomy in a patient with intractable generalized epilepsy. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - February 19, 2016 Category: Neurology Source Type: research
Successful hemispherotomy for a patient with intractable epilepsy secondary to bilateral congenital brain malformation with lateralized pyramidal tract of diffusion tensor image tractography
Publication date: Available online 11 February 2016 Source:Epilepsy & Behavior Case Reports Author(s): Yuri Nagai, Ayataka Fujimoto, Tohru Okanishi, Hironao Motoi, Sotaro Kanai, Takuya Yokota, Hideo Enoki, Mitsuyo Nishimura, Takamichi Yamamoto (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - February 12, 2016 Category: Neurology Source Type: research
Challenges in Identifying Lennox-Gastaut Syndrome in Adults: A Case Series Illustrating its Changing Nature
We present 5 cases that illustrate changes in LGS features over time. Cases 1 and 2 were diagnosed by age 8 with intractable seizures, developmental delay, and abnormal EEGs with 1.5–2Hz SSW discharges. However, seizure type and frequency changed over time for both patients, and the incidence of SSW discharges decreased. Cases 3, 4, and 5 were diagnosed with LGS as adults based on current and past features and symptoms, including treatment-resistant seizures, cognitive and motor impairment, and abnormal EEG findings. While incomplete, their records indicate that an earlier LGS diagnosis may have been missed or lost to hi...
Source: Epilepsy and Behavior Case Reports - February 12, 2016 Category: Neurology Source Type: research
Potential brain language reorganization in a boy with refractory epilepsy; an fNIRS-EEG and fMRI comparison
In this study, we compared functional near infrared spectroscopy (fNIRS) results obtained while the participant performed expressive and receptive language tasks with those obtained using functional magnetic resonance imaging (fMRI). This case study illustrates the potential for NIRS to contribute favourably to the localization of language functions in children with epilepsy and cognitive or behavioural problems and its potential advantages over fMRI in pre-surgical assessment. Moreover, it suggests that fNIRS is sensitive in localizing atypical language network or potential brain reorganization related to epilepsy in youn...
Source: Epilepsy and Behavior Case Reports - February 9, 2016 Category: Neurology Source Type: research
Recruitment of the left precentral gyrus in reading epilepsy: A multimodal neuroimaging study
Conclusion This study is the first to investigate ictogenesis in reading epilepsy during both lexical and phonological reading while using three different multimodal neuroimaging techniques. The somatosensory and motor control functions of the left precentral gyrus that are congruently involved in lexical as well as phonological reading can explain the identical spike localization in both reading pathways. The concurrence between our findings in this study and those from our previous one supports the role of the left precentral gyrus in phonological output computation as well as seizure activity in a case of reading epilep...
Source: Epilepsy and Behavior Case Reports - February 3, 2016 Category: Neurology Source Type: research
Recruitment of the left pre-central gyrus in reading epilepsy: A multimodal neuroimaging study
Conclusion This study is the first to investigate ictogenesis in reading epilepsy during both lexical and phonological reading while using three different multimodal neuroimaging techniques. The somatosensory and motor control functions of the left pre-central gyrus that are congruently involved in lexical as well as phonological reading can explain the identical spike localization in both reading pathways. The concurrence between our findings in this study and those from our previous one support the role of the left pre-central gyrus in phonological output computation as well as seizure activity in a case of reading epile...
Source: Epilepsy and Behavior Case Reports - January 21, 2016 Category: Neurology Source Type: research
Hypothermia associated with clobazam use in adult epilepsy
Publication date: Available online 20 January 2016 Source:Epilepsy & Behavior Case Reports Author(s): Angela C. Gauthier, Imran H. Quraishi, Richard H. Mattson Clobazam, a 1,5-benzodiazepine FDA approved in 2011, is commonly used to treat anxiety and epilepsy. It has never been associated with hypothermia until very recently, in a case report involving two pediatric patients. Here, we report the first case of hypothermia development in an adult epileptic patient associated with clobazam use. A couple months after starting clobazam, the patient started developing episodes of hypothermia every several weeks...
Source: Epilepsy and Behavior Case Reports - January 20, 2016 Category: Neurology Source Type: research
Microsurgical endoscopy-assisted anterior corpus callosotomy for drug-resistant epilepsy in adult unresponsive to vagus nerve stimulation
We present the case of a 21 years-old female with medically refractory drop-attacks that began at the age of 8 years and resulted progressively unresponsive to vagus nerve stimulation implanted at the age of 14 years. Corpus callosotomy was recommended to reduce the number of drop attacks. However, the patient had only mild cognitive impairments and no neurological deficits. For this reason, we were forced to plan a surgical approach able at maximazing the disconnection for a good seizure control while, in the same time, minimizing sequelae from disconnection syndromes and neurosurgical complications, because in such cases...
Source: Epilepsy and Behavior Case Reports - January 20, 2016 Category: Neurology Source Type: research
Paroxysmal belching: Epileptic or nonepileptic?
We present the case of a patient with medically refractory focal epilepsy with simple and complex partial seizures, as well as generalized seizures. One presumed seizure type comprised frequent episodes of repetitive belching. Video-EEG-monitoring during these attacks showed no ictal changes. The belching episodes were inducible and terminable through suggestion. The diagnosis of excessive supragastric belching, a previously described psychogenic condition, was made. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - January 15, 2016 Category: Neurology Source Type: research
Stereotactic laser ablation of the splenium for intractable epilepsy: A case report
We report on the utilization of laser ablation of the splenium in this patient to achieve full corpus callosotomy. Adequate ablation of the splenial remnant was confirmed by post-operative MRI imaging, and at four months follow-up, the patient's seizure frequency had dropped more than 50%. This is the first reported instance of laser ablation of the splenium to achieve full corpus callosotomy following a previous unsuccessful anterior callosotomy in a patient with intractable generalized epilepsy. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - January 13, 2016 Category: Neurology Source Type: research
