scholarly journals Expanding the Spectrum of EEG Periodic Discharges in Subacute Sclerosing Panencephalitis: A Case Report

2021 ◽  
Vol 11 (01) ◽  
pp. e245-e249
Author(s):  
Iliyana Aleksandrova ◽  
Asya Asenova ◽  
Daniela Deneva ◽  
Veneta Bojinova
Keyword(s):  
Case Report ◽  
Slow Wave ◽  
Subacute Sclerosing Panencephalitis ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
High Amplitude ◽  
The Body ◽  
Diagnostic Process ◽  
Sharp Waves ◽  
Eeg Abnormalities

Abstract Background Atypical electroencephalogram (EEG) abnormalities emerge in patients with subacute sclerosing panencephalitis (SSPE), especially in cases with an atypical clinical presentation that can lead to diagnostic difficulties. Case Report In this article, we presented a case of SSPE with an atypical onset with epileptic seizures and Parkinson's features. The neurological examination during the initial evaluation of the patient showed extrapyramidal syndrome, hyperreflexia, intention tremor, and dysmetria. Cranial magnetic resonance imaging was normal. Video EEGs were performed in wakefulness and sleep. In wakefulness, multiple brief seizures (1–1.5 seconds were recorded, consisting of gradual bending of the body forward and to the right that lacked the sudden characteristic of myoclonia. During those episodes, we recorded generalized epileptiform activity of 4 or 5 sharp waves, with higher amplitude in the anterior regions, in some of the paroxysms superimposed on a slow wave or followed by a high amplitude slow wave. The paroxysms appeared periodically every 15 to 30 seconds. However, 2 months later, the EEG showed typical periodic generalized activity of biphasic/triphasic slow waves (Radermecker complexes), accompanied by myoclonias. Conclusion We reported a peculiar EEG pattern in a patient with SSPE that consists of periodic generalized activity of sharp waves. Atypical EEG patterns can appear when the disease progresses, but initially too, before typical periodic complexes and can complicate the diagnostic process.

scholarly journals Continuous spike-and-wave activity during slow-wave sleep in patients with rett syndrome

2021 ◽  
Vol 16 (1-2) ◽  
pp. 63-68
Author(s):  
S. L. Kulikova ◽  
I. V. Kozyreva ◽  
S. A. Likhachev ◽  
M. Yu. Bobylova
Keyword(s):  
Rett Syndrome ◽  
Slow Wave ◽  
Slow Wave Sleep ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
High Amplitude ◽  
Speech Development ◽  
Early Age ◽  
Entire Observation Period ◽  
Observation Period

The article presents a description of a clinical case of a child 3 years 8 months old with Rett syndrome caused by the mutation of p.Val485fs in the MECP2 gene. According to electroencephalography data at the age of 1 year and 6 months, diffuse continued epileptiform activity in the form of high-amplitude (up to 300 μV) acute – slow wave complexes (continuous spike-waves during slow-wave sleep, CSWS) with an index of 90–100 % was revealed. At the control examination at the age of 2 years and 10 months diffuse epileptiform activity was replaced by multifocal activity with an index of up to 70–80 % at certain epochs, in general, not exceeding 50–60 %. During the entire observation period there were no epileptic seizures. It remains unknown whether the presence of CSWS at such an early age is a predictor of a more severe course of Rett syndrome – in our observation the girl did not acquire walking skills and a delay in psychic and speech development was evident already before the 12 month of life. more research is needed on the frequency of the CSWS phenomenon and its role in the development of clinical features in Rett syndrome.

scholarly journals Aggravation of symptomatic occipital epilepsy of childhood by carbamazepine

2014 ◽  
Vol 71 (4) ◽  
pp. 404-407 ◽  
Author(s):  
Fadil Skrijelj ◽  
Mersudin Mulic
Keyword(s):  
Slow Wave ◽  
Clinical Manifestations ◽  
Brain Magnetic Resonance Imaging ◽  
Poor Performance ◽  
Epileptic Seizures ◽  
High Amplitude ◽  
Psychomotor Development ◽  
Vacuum Extraction ◽  
Sharp Waves ◽  
Normal Limits

Introduction. Carbamazepine can lead to aggravation of epileptic seizures in generalized epilepsies (primary or secondary) with clinical manifestations of absence (typical or atypical) and/or myoclonic seizures. However, some focal epilepsies can be also aggravated by the introduction of carbamazepine. Case report. We presented a 10-year-old boy born after a complicated and prolonged delivery completed by vacuum extraction, of early psychomotor development within normal limits. At the age of 8 years he had the first epileptic seizure of simple occipital type with generalization and urination. Brain magnetic resonance imaging (MRI) showed focal cortical reductions in the left parietal and occipital regions. Interictal EEG recorded slowed basic activities above the posterior regions of the left hemisphere, with intermittent occurrence of occipital sharp waves and bioccipital sharp and slow-wave complexes. Initially, treatment with valproate was administered; however, the addition of carbamazepine into therapy induced aggravation of seizures and EEG findings, changed behavior and poor performance at school. By withdrawal of carbamazepine the condition improved both clinically and in EEG findings. Conclusion. Childhood occipital epilepsy lesions show deterioration due to carbamazepine, which if administered induces aggravation of seizures, behavior changes, cognition with occurrence of long-term bilateral discharges, and posterior sharp and slow wave high amplitude complexes recorded by EEG.

Seizures with Apnea in Children

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 87-90
Author(s):  
Kazuyoshi Watanabe ◽  
Kimiko Hara ◽  
Susumu Hakamada ◽  
Tamiko Negoro ◽  
Midori Sugiura ◽  
...  
Keyword(s):  
Limbic System ◽  
Epileptic Seizures ◽  
High Amplitude ◽  
The Other ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Sharp Waves ◽  
Fast Waves ◽  
Respiratory Embarrassment ◽  
Epileptic Fits

Five children who had apneic attacks as a manifestation of epileptic seizures are reported. In three children, the apneic attacks were the sole symptom of epileptic fits. The other two children had additional types of seizures. The apneic seizures usually lasted one to two minutes and were characterized by respiratory embarrassment rather than complete arrest. These seizures are usually accompanied by cyanosis which appears early during the course of the attack. Although consciousness seemed to be impaired, this was difficult to assess accurately in infants. The ictal EEGs disclosed paroxysmal discharges of focal onset in all cases, consisting of high amplitude θ-waves, gradually mixed with or replaced by sharp waves or spikes in some and fast waves followed by slower waves in others. These occurred in temporal areas in three patients and in frontal and central areas in one patient each. Interictal EEGs, however, revealed paroxysmal discharges in only one patient. Apneic attacks in these infants are considered to be an integral part of the manifestations of complex partial seizures originating mostly in the limbic system.

scholarly journals Cat-scratch fever in a 14-year-old girl – a case report

2020 ◽  
Vol 16 (3) ◽  
pp. 316-319
Author(s):  
Agnieszka Lipińska-Opałka ◽  
◽  
Agata Wawrzyniak ◽  
Agnieszka Gościńska ◽  
Izabela Paszkowska ◽  
...  
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Medical History ◽  
Clinical Presentation ◽  
Bartonella Henselae ◽  
Epidemiological Data ◽  
The Body ◽  
Diagnostic Process ◽  
History Plays ◽  
Rule Out

Cat-scratch fever is a bacterial zoonotic disease most commonly caused by the bacteria Bartonella henselae. In the majority of cases, the pathogens enter the body as a consequence of a scratch by young cats. The disease usually presents as local lymphadenopathy and resolves spontaneously over a period of 8–12 weeks. The epidemiological status of bartonellosis in Poland varies. According to the latest epidemiological data, a total of 36 cases of the disease were reported in 2008, with 75% of cases requiring hospitalisation. The clinical presentation of cat-scratch fever is often non-specific, so a wide panel of tests is required to rule out other diseases that may be accompanied by local lymphadenopathy. The disease is usually mild and selflimiting, but some patients may require antibiotic therapy. The case reported here shows that a thorough evaluation of medical history plays a key role in the diagnostic process, providing a rapid and accurate preliminary diagnosis.

scholarly journals Case Report: Corpus Callosotomy in a Cat With Drug-Resistant Epilepsy of Unknown Cause

2021 ◽  
Vol 8 ◽  
Author(s):  
Daisuke Hasegawa ◽  
Rikako Asada ◽  
Satoshi Mizuno ◽  
Yoshihiko Yu ◽  
Yuji Hamamoto ◽  
...  
Keyword(s):  
Case Report ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Intact Male ◽  
Fluid Analysis ◽  
Postoperative Mri ◽  
Visual Analog Scales ◽  
Eeg Abnormalities ◽  
Drug Resistant Epilepsy

A 2-month-old, intact male domestic shorthair cat with dullness, bilateral central blindness, and recurrent epileptic seizures was presented to a local clinic. Seizures were the generalized myoclonic and tonic-clonic type. Phenobarbital was initiated and maintained; however, seizures were not controlled. Other anti-seizure drugs, including levetiracetam, zonisamide, and diazepam, also provided insufficient seizure control with seizures occurring hourly to daily. By 8 months of age, the cat displayed non-ambulatory tetraparesis and deep somnolence. Magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and pre- and post-prandial total bile acid analyses were unremarkable. Scalp electroencephalography (EEG) revealed central dominant but generally synchronized spikes and multiple spikes. The cat was diagnosed with drug-resistant epilepsy of unknown cause and was included in a clinical trial of epilepsy surgery. Given the unremarkable MRI and bilateral synchronized EEG abnormalities, a corpus callosotomy was performed at 12 months of age, and partial desynchronization of spikes was confirmed on EEG. Incomplete transection was found in the genu of the corpus callosum on postoperative MRI. After surgery, the mental status and ambulation clearly improved, and seizure frequency and duration were remarkably reduced. Recheck with follow-up EEG and MRI were performed at 3, 6, and 12 months after surgery. Scores of activities of daily living and visual analog scales including cat's and owner's quality of life had also improved considerably. This case report is the first documentation of the one-year clinical outcome of corpus callosotomy in a clinical feline case with drug-resistant epilepsy.

Neonatal Gastric Web Located in the Body of Stomach: A Case Report

2006 ◽  
Vol 54 (1) ◽  
pp. 39
Author(s):  
Jun Hyun Yun ◽  
Hyun Jun Choi ◽  
Ji Hyeo Choi ◽  
Ju Hyun Im ◽  
Se Jong Kim ◽  
...  
Keyword(s):  
Case Report ◽  
The Body

Case report: a child with cystic fibrosis and phenylketonuria

2020 ◽  
Vol 1 (2) ◽  
pp. 38-44
Author(s):  
Irina V. Vakhlova ◽  
Anastasia D. Kazachina ◽  
Olga A. Beglyanina
Keyword(s):  
Cystic Fibrosis ◽  
Case Report ◽  
Clinical Practice ◽  
Neonatal Screening ◽  
Genetic Disorders ◽  
Epileptiform Activity ◽  
Autism Spectrum ◽  
Speech Development ◽  
Inherited Disorders ◽  
Congenital Diseases

Background. In the international clinical practice there have been occasional reports of phenylketonuria (PKU) and cystic fibrosis (CF) found simultaneously in the same patient. Both PKU and CF are the inherited disorders characterized by autosomal recessive type of inheritance. Currently the combination of two or more inherited disorders in one patient is considered to be a clinical rarity.Case description. This is a clinical case of two genetic disorders, CF and PKU, combined in a 5-year old patient who had been followed up since birth. Owing to implementation of neonatal screening for inherited and congenital diseases into clinical practice, during the first month of life the infant was diagnosed with CF (diagnostically significant elevation of immunoreactive trypsin [IRT] at the initial [163.2 ng/mL] and repeat testing on day 21 of life [138.7 ng/mL]) and PKU (phenylalanine [PA] level 15.9 mg/dL). Both disorders have been confirmed by genetic tests, i.e., homozygous DelF508 mutation was found in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, and P281L mutation in the phenylalanine hydroxylase (PAH) gene was also present in homozygous state. Child’s parents strictly adhered to dietary and treatment recommendations. By the age of 5 years the child developed symptoms of neurological disorder and disorder of the respiratory system, cognitive impairment and delay in speech development, subclinical epileptiform activity with high risk of epilepsy, and chronic inflammation of the respiratory tract.Conclusion. This case report demonstrates the important role of neonatal screening in early diagnosis and timely start of therapy, and underscores the importance of continuous medication in such genetic disorders as CF and PKU. On the whole, such approach brings about a relative preservation of functioning of the most affected organs and systems. By the age of 5 years the child does not form bronchiectases, shows no signs of chronic hypoxia, nutritional deficiency or pronounced neurologic deficit, and is at low risk for the development of autism spectrum disorder. At the same time, the larger scale and longer-term observations are required in order to make the unequivocal conclusions about the prognosis of these diseases under conditions of modern-day medical follow-up.

A Case Report on Glanzmann’s Thrombasthenia: A Rare Platelet Function Disorder

2018 ◽  
Vol 2 (02) ◽  
pp. 59-60
Author(s):  
Farida Yasmin ◽  
Md. Anwarul Karim ◽  
Chowdhury Yakub Jamal ◽  
Mamtaz Begum ◽  
Ferdousi Begum
Keyword(s):  
Case Report ◽  
Platelet Function ◽  
The Body ◽  
Presenting Symptoms ◽  
Glanzmann’S Thrombasthenia ◽  
Glanzmann's Thrombasthenia ◽  
Platelet Function Disorders ◽  
Recurrent Epistaxis ◽  
Severe Epistaxis ◽  
History Of

Epistaxis in children is one of the important presenting symptoms for attending emergency department in paediatric patients. Recurrent epistaxis is common in children. Although epistaxis in children usually occurred due to different benign conditions, it may be one of the important presenting symptoms of some inherited bleeding disorder. Whereas most bleeding disorders can be diagnosed through different standard hematologic assessments, diagnosing rare platelet function disorders may be challenging. In this article we describe one case report of platelet function disorders on Glanzmann’s thrombasthenia (GT). Our patient was a 10-year old girl who presented to us with history of recurrent severe epistaxis. She had a bruise on her abdomen and many scattered petechiae in different parts of the body. Her previous investigations revealed no demonstrable haemostatic anomalies. After performing platelet aggregation test, she was diagnosed as GT.

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

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