Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox–Gastaut syndrome
We report a child with Lennox–Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. After three days EEG recording demonstrated a non-convulsive status epilepticus that could only be halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor developme...
Source: Epilepsy and Behavior Case Reports - September 13, 2018 Category: Neurology Source Type: research
Auras localized to the temporal lobe disrupt verbal memory and learning — Causal evidence from direct electrical stimulation of the hippocampus
Publication date: 2018Source: Epilepsy & Behavior Case Reports, Volume 10Author(s): Diana Pizarro, Emilia Toth, Auriana Irannejad, Kristen O. Riley, Zeenat Jaisani, Wolfgang Muhlhofer, Roy Martin, Sandipan PatiAbstractAuras (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 ...
Source: Epilepsy and Behavior Case Reports - September 2, 2018 Category: Neurology Source Type: research
Extra operative intracranial EEG monitoring for epilepsy surgery in elderly patients
ConclusionWe noticed an increased utilization of eiEEG in elderly patients after the introduction of SEEG at our center. Overall, we found that eiEEG can help achieve good seizure outcomes in the elderly population. However, the one eiEEG-related mortality serves a word of caution about the potential risks in this population. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - August 14, 2018 Category: Neurology Source Type: research
Auras localized to the temporal lobe disrupt verbal memory and learning- causal evidence from direct electrical stimulation of the hippocampus
Publication date: Available online 3 August 2018Source: Epilepsy & Behavior Case ReportsAuthor(s): Diana Pizarro, Emilia Toth, Auriana Irannejad, Kristen O. Riley, Zeenat Jaisani, Wolfgang Muhlhofer, Roy Martin, Sandipan PatiAbstractAuras (Focal aware seizures-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 epilep...
Source: Epilepsy and Behavior Case Reports - August 3, 2018 Category: Neurology Source Type: research
Improvement in anti-N-methyl-D-aspartate receptor antibody-mediated temporal lobe epilepsy with amygdala enlargement without immunotherapy
Publication date: Available online 3 August 2018Source: Epilepsy & Behavior Case ReportsAuthor(s): Go Taniguchi, Hitomi Fuse, Yumiko Okamura, Harushi Mori, Shinsuke Kondo, Kiyoto Kasai, Yukitoshi Takahashi, Keiko TanakaAbstractFocal neuroinflammation is considered one of the hypotheses for the cause of temporal lobe epilepsy (TLE) with amygdala enlargement (AE). Here, we report a case involving an adult female patient with TLE-AE characterized by late-onset seizures and cognitive impairment. Anti-N-methyl-D-aspartate receptor (NMDAR) antibodies were detected in her cerebrospinal fluid. However, administration of appropriat...
Source: Epilepsy and Behavior Case Reports - August 3, 2018 Category: Neurology Source Type: research
A case of interictal dysphoric disorder comorbid with interictal psychosis: Part of the same spectrum or separate entities?
Publication date: Available online 3 August 2018Source: Epilepsy & Behavior Case ReportsAuthor(s): Susumu Morita, Go Taniguchi, Hidetaka Tamune, Yousuke Kumakura, Shinsuke Kondo, Kiyoto KasaiAbstractDepressive disorders in epilepsy often present characteristic clinical manifestations atypical in primary, endogenous depression. Here, we report a case of a 64-year-old woman with right mesial temporal lobe epilepsy, who complained of bizarre, antipsychotic-refractory cenesthetic hallucinations in her interictal phase, and was hospitalized after a suicide attempt. Detailed clinical observations revealed mood symptoms, which le...
Source: Epilepsy and Behavior Case Reports - August 3, 2018 Category: Neurology Source Type: research
Working memory deficit in drug-resistant epilepsy with an amygdala lesion
This study compared temporal lobe epilepsy (TLE) patients with amygdala lesion (AL) without hippocampal sclerosis (HS) (TLE-AL) with patients with TLE and HS without AL (TLE-HS). Both subtypes of TLE arose from the right hemisphere.The TLE-AL group exhibited a lower Working Memory Index (WMI) on the Wechsler Adult Intelligence Scale, third edition (WAIS-III), indicating that the amygdala in the right hemisphere is involved in memory-related function. [18F]fluorodeoxyglucose positron emission topography (FDG-PET) showed glucose hypometabolism limited to the right uncus for the TLE-AL group.The results suggest the importance...
Source: Epilepsy and Behavior Case Reports - July 30, 2018 Category: Neurology Source Type: research
Epilepsy and concomitant obsessive–compulsive disorder
Publication date: Available online 20 July 2018Source: Epilepsy & Behavior Case ReportsAuthor(s): Emiy Shah, Jacob S. Bird, Paul ShotboltAbstractPeople with epilepsy (PWE) often suffer psychiatric symptoms which can impact them more than seizures. Affective and psychotic disorders are well recognised as occurring more frequently in PWE than the general population. Less is known about obsessive–compulsive disorder (OCD) in PWE, despite it being as disabling and distressing. We sought to explore the association between epilepsy and OCD with case-reports by identifying ten PWE and concomitant OCD. Demographics, seizure clas...
Source: Epilepsy and Behavior Case Reports - July 20, 2018 Category: Neurology Source Type: research
Extra-operative, intracranial EEG monitoring for epilepsy surgery in the elderly patients
ConclusionWe noticed an increased utilization of eiEEG in elderly patients after the introduction of relatively safe technique of SEEG at our center. Overall, we found that eiEEG can help achieve good seizure outcomes in the elderly population. However, the one eiEEG related mortality serves a word of caution about the potential risks in this population. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - July 18, 2018 Category: Neurology Source Type: research
Working memory deficit in intractable epilepsy with amygdala lesion
This study compared temporal lobe epilepsy (TLE) patients with amygdala lesion (AL) without hippocampal sclerosis (HS) (TLE-AL) and TLE with HS without AL (TLE-HS) (both in the right hemisphere).The TLE-AL group exhibited lower Working Memory Index (WMI) in Wechsler Adult Intelligence Scale, Third Edition (WAIS-III), indicating that the amygdala in the right hemisphere is involved in memory-related function. [18F]fluoro-deoxyglucose positron emission topography (FDG-PET) showed glucose hypometabolism limited in the right uncus for the TLE-AL group.The results suggest the importance of closer attention to cognitive function...
Source: Epilepsy and Behavior Case Reports - July 18, 2018 Category: Neurology Source Type: research
Successful use of pure cannabidiol for the treatment of super-refractory status epilepticus
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. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - July 18, 2018 Category: Neurology Source Type: research
Compound heterozygosity with PRRT2: Pushing the phenotypic envelope in genetic epilepsies
We describe a patient with compound heterozygous variants, infantile epilepsy with status epilepticus, paroxysmal dyskinesia and episodic ataxia.Testing revealed a pathogenic PRRT2 duplication (c.649dupC), and a likely pathogenic missense variant (c.916G>A).His presentation meets the severe phenotypic category with a combination of at least 3 neurological symptoms: seizures and status epilepticus, prolonged episodic ataxia, and paroxysmal dyskinesia. This further expands the clinical findings related to PRRT2, and suggests that compound heterozygous variants could confer a severe phenotype. (Source: Epilepsy and Behavior Case Reports)
Source: Epilepsy and Behavior Case Reports - July 10, 2018 Category: Neurology Source Type: research
Teratoma-negative anti-NMDA receptor encephalitis presenting with a single generalized tonic–clonic seizure
Publication date: 2018Source: Epilepsy & Behavior Case Reports, Volume 10Author(s): Andy Cheuk-Him Ng, Miljan Tripic, Seyed M. MirsattariAbstractHerein, we describe a case report of anti-NMDA receptor encephalitis characterized by a single generalized tonic–clonic seizure and predominantly psychiatric symptoms, persisting long after EEG abnormalities had resolved. We discuss common presentations of anti-NMDA receptor encephalitis and advocate for the inclusion of this disease entity in the differential diagnosis of patients presenting with one generalized tonic–clonic seizure and prominent psychiatric symptoms. (Source...
Source: Epilepsy and Behavior Case Reports - July 10, 2018 Category: Neurology Source Type: research
Seizure remission and improvement of neurological function in sialidosis with perampanel therapy
Publication date: 2018Source: Epilepsy & Behavior Case Reports, Volume 10Author(s): Su-Ching Hu, Kun-Long Hung, Hui-Ju Chen, Wang-Tso LeeAbstractA 15-year-old boy experienced myoclonic seizures for 3 years. He initially had occasional myoclonus, gradually progressive ataxia, tremors, and psychomotor and speech regression developed. Eventually, he exhibited nearly continuous myoclonus. He received treatment of sodium valproate, levetiracetam, clobazam, and phenobarbital, without efficacy. A ketogenic diet also proved ineffective. Adjunctive therapy with 4 mg/day of perampanel was started and was gradually titrated...
Source: Epilepsy and Behavior Case Reports - July 10, 2018 Category: Neurology Source Type: research
Lacosamide may improve cognition in patients with focal epilepsy: EpiTrack to compare cognitive side effects of lacosamide and carbamazepine
Publication date: 2018Source: Epilepsy & Behavior Case Reports, Volume 10Author(s): Claudio Liguori, Francesca Izzi, Natalia Manfredi, Nicola Biagio Mercuri, Fabio PlacidiAbstractCarbamazepine (CBZ) is a first generation anti-seizure drug, considered as first choice therapy in focal epilepsy but associated with cognitive side effects. Lacosamide (LCM) is a third-generation anti-seizure drug approved for treating focal epilepsy. This case series documented the comparable efficacy of LCM and CBZ as first add on treatments in patients affected by uncontrolled focal seizures. LCM showed an increase in EpiTrack scores, which me...
Source: Epilepsy and Behavior Case Reports - July 10, 2018 Category: Neurology Source Type: research
