scholarly journals P.013 Convulsive status epilepticus due to intracranial hypotension

2018 ◽  
Vol 45 (s2) ◽  
pp. S19-S19
Author(s):  
GS Gilmour ◽  
J Scott ◽  
P Couillard
Keyword(s):  
Status Epilepticus ◽  
Intracranial Hypotension ◽  
Chronic Back Pain ◽  
Case Reports ◽  
Convulsive Status Epilepticus ◽  
Scoliosis Surgery ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Epileptiform Discharges ◽  
Cortical Vein Thrombosis

Background: Intracranial hypotension (IH) is typically characterized by an orthostatic headache. There have been limited case reports describing iatrogenic IH presenting with seizures. Methods: Case report. Results: A 71-year-old woman with chronic back pain developed convulsive status epilepticus (SE), characterized by generalized clonic seizures, immediately following scoliosis surgery. She had no history of seizures or seizure risk factors. Despite treatment with Midazolam, Phenytoin and Lacosamide, seizures recurred five times over three hours. Thus, Propofol and Midazolam infusions were initiated. An electroencephalogram revealed burst suppression and bilateral hemispheric epileptiform discharges. MRI brain was consistent with IH without cortical vein thrombosis. Fluid from the surgical drains was positive for Beta-2 transferrin, indicating cerebral spinal fluid. Her intracranial hypotension was likely due to an -intraoperative dural tear causing SE. Over two weeks, she remained on bedrest, sedation was weaned, and Phenytoin and Lacosamide were tapered and discontinued. She had no further seizures. Conclusions: IH is an under recognized cause of seizure following spinal or cranial surgery, lumbar puncture, or spinal anaesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow and cortical irritation secondary to subdural hygromas.

scholarly journals Isolated cortical vein thrombosis: case series

2015 ◽  
Vol 123 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Ranjodh Singh ◽  
William P. Cope ◽  
Zhiping Zhou ◽  
Michelle E. De Witt ◽  
John A. Boockvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Hypotension ◽  
Vasogenic Edema ◽  
Anticoagulation Therapy ◽  
Case Series ◽  
Published Data ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Presenting Symptoms ◽  
Cortical Vein Thrombosis

OBJECT Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. This case series and literature review presents the clinical and radiological findings in 7 patients with ICVT, and highlights risk factors and imaging modalities that may be most beneficial in rendering an accurate and timely diagnosis. METHODS Patients with CT and MRI findings consistent with ICVT examined between January 2011 and June 2014 were included in this retrospective review. RESULTS Seven patients (5 females, 2 males), ranging in age from 11 months to 34 years, met the inclusion criteria. The most common clinical presentations were headaches (n = 4) and seizures (n = 3). The most common comorbidities noted in these patients were hypercoagulable states (n = 4) and intracranial hypotension (n = 3). Five patients had intraparenchymal involvement. CT suggested the correct diagnosis in 4 patients, and MRI confirmed the diagnosis in all 7 patients. All patients who received anticoagulation therapy (n = 5) experienced complete resolution of their symptoms. CONCLUSIONS The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.

scholarly journals Cerebral venous thrombosis following spontaneous intracranial hypotension diagnosed by craniotomy: A case report and diagnostic pitfalls

2021 ◽  
Vol 12 ◽  
pp. 367
Author(s):  
Shigeomi Yokoya ◽  
Hideki Oka ◽  
Akihiko Hino
Keyword(s):  
Intracranial Hypotension ◽  
Sinus Thrombosis ◽  
Fluid Pressure ◽  
Spontaneous Intracranial Hypotension ◽  
Dural Sinus ◽  
Cerebral Vein ◽  
Imaging Findings ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

Background: Cerebral vein and dural sinus thrombosis (CVT) is a rare but important complication of spontaneous intracranial hypotension (SIH). The diagnosis is difficult in cases lacking typical symptoms and typical imaging findings. Case Description: A 29-year-old male patient with a seizure attack was admitted to our hospital. Based on the head imaging findings, we misdiagnosed the patient with primary cerebral parenchymal lesion and performed an open biopsy. However, during the procedure, the patient was diagnosed with low cerebrospinal fluid pressure and cerebral cortical vein thrombosis. Conclusion: Thus, CVT due to SIH should be considered as a probable cause of secondary parenchymal lesions.

scholarly journals Electroencephalographic abnormalities in COVID-19-related encephalopathies: A systematic review

2020 ◽  
Vol 8 (35) ◽  
pp. 36-41
Author(s):  
Jie Pan ◽  
Shazma Khan ◽  
Smathorn Thakolwiboon ◽  
Dargelis Chi
Keyword(s):  
Status Epilepticus ◽  
Case Reports ◽  
Neurological Complication ◽  
Case Series ◽  
Convulsive Status Epilepticus ◽  
Acute Encephalopathy ◽  
Case Control Studies ◽  
Retrospective Case ◽  
Epileptiform Discharges ◽  
Slow Activity

Background: Acute encephalopathy is a common neurological manifestation in coronavirus disease 2019 (COVID-19) patients and presents with confusion, delirium, or poor responsiveness. Non-convulsive status epilepticus (NCSE) is an important differential diagnosis in this situation. The electroencephalography (EEG) patterns in COVID-19 patients remain largely unknown. Method: A literature search was conducted on MEDLINE, EMBASE, and Cochrane database. Eligibility criteria included case series and case reports of COVID-19 patients with neurological complication who underwent EEG. Two authors screened all resulting studies and extracted the data independently. Results: Four retrospective case control studies and eleven case reports were identified. Background diffuse slow activity were seen in most of the COVID-19 patients. Other EEG patterns reported included status epilepticus, focal slow activity, rhythmic periodic discharges, and interictal epileptiform discharges. Imaging and CSF studies were available in only a few patients. Conclusions: Acute encephalopathy is common in the context of COVID-19. There is no specific EEG pattern found in these patients. Keywords: COVID-19, coronavirus, SAR-CoV-2, electroencephalogram, EEG

Multimodal diagnosis of cortical vein thrombosis

2007 ◽  
Vol 34 (S 2) ◽  
Author(s):  
J Linn ◽  
T Pfefferkorn ◽  
S Michl ◽  
M Wiesmann ◽  
S Hartz ◽  
...  
Keyword(s):  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

scholarly journals Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Yu Chen ◽  
Bin Cui ◽  
Tianyi Xiao
Keyword(s):  
Venous Thrombosis ◽  
Polycythemia Vera ◽  
Delayed Diagnosis ◽  
Janus Kinase ◽  
Cerebellar Hemisphere ◽  
Cerebellar Tumor ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
V617f Mutation

Abstract Background Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon. Case presentation This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation. Conclusion Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.

Isolated cortical vein thrombosis in a patient with sickle cell disease: Treatment with decompressive craniotomy and anticoagulation and literature review

2013 ◽  
Vol 61 (2) ◽  
pp. 173 ◽  
Author(s):  
PedroTadao Hamamoto Filho ◽  
RobertoColichio Gabarra ◽  
GabrielPereira Braga ◽  
LucileneSilva Ruiz e Resende ◽  
Rodrigo Bazan ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Literature Review ◽  
Sickle Cell ◽  
Cell Disease ◽  
Disease Treatment ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Decompressive Craniotomy ◽  
Cortical Vein Thrombosis

scholarly journals Malignant isolated cortical vein thrombosis with type II protein S deficiency: a case report

BMC Neurology ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Nobuhiko Arai ◽  
Masanao Tabuse ◽  
Akiyoshi Nakamura ◽  
Hiromichi Miyazaki
Keyword(s):  
Case Report ◽  
Protein S ◽  
Type Ii ◽  
Protein S Deficiency ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
S Deficiency

De novo convulsive status epilepticus in patients with multiple sclerosis treated with dalfampridine

2018 ◽  
Vol 25 (4) ◽  
pp. 618-621 ◽  
Author(s):  
Emilie Panicucci ◽  
Mikael Cohen ◽  
Veronique Bourg ◽  
Fanny Rocher ◽  
Pierre Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Status Epilepticus ◽  
De Novo ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Convulsive Status Epilepticus ◽  
Biological Tests ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
History Of Epilepsy

Background: Dalfampridine extended release (DAL) is a broad-spectrum voltage-gated potassium channel blocker that is indicated in multiple sclerosis to improve the nerve conduction of demyelinated axons. Seizures are a known side effect of DAL, which is contraindicated in patients with a history of epilepsy. Objective: Three cases of multiple sclerosis (MS) with de novo convulsive status epilepticus (CSE) probably related to dalfampridine administration are described. Methods: No patients had a history of seizures or renal impairment. Biological tests were normal. A brain magnetic resonance imaging (MRI) showed diffuse cortical and subcortical atrophy without active inflammatory lesions. Results: All three patients presented with CSE that was attributed to DAL and so was discontinued. Conclusion: These case reports illustrate that, aside from seizures, de novo CSE is a potential complication of MS patients treated with DAL.

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