scholarly journals Three Cases of Aphasic Status Epilepticus: Clinical and Electrographic Characteristics

2021 ◽  
Vol 14 ◽  
pp. 117954762110092
Author(s):  
Jung-Ju Lee ◽  
Jong-Moo Park ◽  
Kyusik Kang ◽  
Ohyun Kwon ◽  
Woong-Woo Lee ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drug ◽  
Rhythmic Activity ◽  
Cerebral Lesions ◽  
High Blood Glucose ◽  
Adequate Treatment ◽  
Woman Patient ◽  
Epileptiform Discharges ◽  
The Right ◽  
Frontotemporal Area

Aphasic status epilepticus (ASE) is unusual and has clinical characteristics similar to those of other disorders. Herein, we report 3 cases of ASE. A left-handed man (patient 1) showed continuous aphasia after the administration of flumazenil. He had underlying alcoholic liver cirrhosis and traumatic brain lesions in the right hemisphere. Electroencephalography (EEG) revealed periodic epileptiform discharges in the right frontotemporal area, which were intervened by rhythmic activity with spatiotemporal evolutions. A right-handed woman (patient 2) showed recurrent aphasia. Blood tests revealed a high blood glucose level (546 mg/dL) and high serum osmolality (309 mMol/L). Her EEG showed rhythmic activity in the left frontotemporal area with spatiotemporal evolutions on a normal background rhythm. She became seizure-free after the administration of an antiepileptic drug and strict glucose regulation. A right-handed woman (patient 3) developed subacute aphasia a week before hospital admission. She had a gradual decline of cognition 1 year before. Her EEG showed intermittent quasi-rhythmic fast activity in the frontotemporal area bilaterally, with fluctuating frequency and amplitude. The patient became seizure-free after the administration of an antiepileptic drug. Brain single-photon emission tomography performed after seizure control showed decreased perfusion in the left frontotemporal area. After discharge, her cognitive function gradually declined to a severe state of dementia. ASE can be caused by diverse etiologies; it is usually caused by cerebral lesions and less frequently by non-lesional etiologies or degenerative disorders. Adequate treatment of underlying disorders and seizures is critical for curing the symptoms of ASE.

scholarly journals Neonatal seizures: the overlap between diagnosis of metabolic disorders and structural abnormalities. Case report

2003 ◽  
Vol 61 (2B) ◽  
pp. 478-481 ◽  
Author(s):  
Alessandra Freitas ◽  
Erasmo B. Casella ◽  
Marcelo Valente ◽  
Carlos A Buchpiguel ◽  
Kette D.R. Valente
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Serum Levels ◽  
High Serum ◽  
Neonatal Seizures ◽  
Epileptiform Discharges ◽  
Anti Epileptic Drug ◽  
Malformation Of Cortical Development ◽  
Metabolic Investigation ◽  
The Right

Inborn metabolic errors (IME) and cortical developmental malformations are uncommon etiologies of neonatal seizures, however they may represent treatable causes of refractory epilepsy and for this reason must be considered as possible etiological factors. This case report aims to demonstrate the importance of neuroimaging studies in one patient with neonatal seizures, even when there are clues pointing to a metabolic disorder. CASE REPORT: A previously healthy 14 day-old child started presenting reiterated focal motor seizures (FMS) which evolved to status epilepticus. Exams showed high serum levels of ammonia and no other abnormalities. A metabolic investigation was conducted with normal results. During follow-up, the patient presented developmental delay and left side hemiparesia. Seizures remained controlled with anti-epileptic drugs for four months, followed by relapse with repetitive FMS on the left side. Temporary improvement was obtained with anti-epileptic drug adjustment. At the age of 6 months, during a new episode of status epilepticus, high ammonia levels were detected. Other metabolic exams remained normal. The child was referred to a video-electroencephalographic monitoring and continuous epileptiform discharges were recorded over the right parasagittal and midline regions, with predominance over the posterior quadrant. A new neuroimaging study was performed and displayed a malformation of cortical development. Our case illustrates that because newborns are prone to present metabolic disarrangement, an unbalance such as hyperammonemia may be a consequence of acute events and conduct to a misdiagnosis of IME.

Status Epilepticus in Children With Epilepsy: The Role of Antiepileptic Drug Levels in Prevention

PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1119-1121
Author(s):  
Joseph Maytal ◽  
Gerald Novak ◽  
Catherine Ascher ◽  
Robert Bienkowski
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drug ◽  
Medical Records ◽  
Clinic Visit ◽  
Drug Levels ◽  
Progressive Encephalopathy ◽  
History Of ◽  
The Mean ◽  
Subtherapeutic Level

Objectives. To determine the association between subtherapeutic antiepileptic drug (AED) levels or AED withdrawal and status epilepticus (SE) in children with epilepsy. Methods. We studied the AED levels at the time of SE in 51 consecutive children with epilepsy. Information about prior AED levels, possible etiology of seizures, and acute precipitants was extracted from medical records. Results. The mean age at the time of SE was 5.7 years (range, 3 months through 18 years). Forty-three patients had history of remote insult, five had history of progressive encephalopathy, and three patients were classified as idiopathic. At the time of SE all AED levels were therapeutic in 34 (66%) patients and at least one level was therapeutic in 42 (82%) patients. All levels were subtherapeutic in 9 (18%) patients. Four patients had their AED reduced or discontinued less than 1 week before SE. Twelve patients with therapeutic AED levels on their most recent clinic visit had at least one subtherapeutic level at the time of SE. Eight (16%) patients were febrile and one was hyponatremic. Of the 51 patients, 31 (61%) had no obvious explanation for the development of SE, as all known AEDs were therapeutic and there were no known acute insults. Conclusions. Neurologically abnormal children with preexisting epilepsy are at high risk for development of SE despite having therapeutic AED levels at that time. Acute precipitants of SE, such as fever or AED withdrawal, may play a role in inducing SE only in a minority of patients.

Early Epileptiform Discharges and Clinical Signs Predict Nonconvulsive Status Epilepticus on Continuous EEG

2018 ◽  
Vol 29 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Johannes Koren ◽  
Johannes Herta ◽  
Simone Draschtak ◽  
Georg Pötzl ◽  
Franz Fürbass ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Clinical Signs ◽  
Nonconvulsive Status Epilepticus ◽  
Epileptiform Discharges ◽  
Continuous Eeg

scholarly journals About the neurolinguistics of the implicatures: abstract of a study

1989 ◽  
Vol 47 (2) ◽  
pp. 254-255
Author(s):  
Juliano Luís Fontanari
Keyword(s):  
Right Hemisphere ◽  
Clinical Manifestations ◽  
Brain Lesions ◽  
Cerebral Lesions ◽  
The Right

Taking into account recent data on linguistics of production and comprehension in aphasia, a protocol was executed including the several types of implicatures. The protocol was applied to 90 subjects classified according to the localization of cerebral lesions, as shown by CT. Results are discussed in report to clinical manifestations of brain lesions, as aphasia, apraxia, agnosia, and intelligence and pragmatics disturbances. Discussion supports the impression that there is a mechanism that correlates extra-linguistics contexts with the 'said' at the right hemisphere.

scholarly journals Nonconvulsive status epilepticus associated with Alzheimer’s disease mimicking symptomatic focal epilepsy following the resection of a frontal parasagittal meningioma

2020 ◽  
Vol 11 ◽  
pp. 469
Author(s):  
Keisuke Abe ◽  
Nobutaka Mukae ◽  
Takato Morioka ◽  
Yuhei Sangatsuda ◽  
Ayumi Sakata ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Status Epilepticus ◽  
Focal Epilepsy ◽  
Nonconvulsive Status Epilepticus ◽  
Histopathological Diagnosis ◽  
Epileptogenic Lesion ◽  
Consciousness Disorder ◽  
Impaired Awareness ◽  
The Right

Background: Epilepsies are frequent in patients with Alzheimer’s disease (AD); however, epilepsies in AD can easily go unrecognized because they usually present as focal impaired awareness seizures or nonconvulsive status epilepticus (NCSE) and can overlap with other symptoms of AD. Case Description: We performed an epilepsy surgery in a 69-year-old woman with progressive cognitive impairment and consciousness disorder, who was diagnosed with focal NCSE related to the resected meningioma in the right frontal parasagittal region. Intraoperative electrocorticography revealed localized periodic paroxysmal discharges with beta and gamma activities in the neighboring cortex where the meningioma existed. The histopathological diagnosis of AD was first made from the resected epileptogenic cortex. Conclusion: Even when there is a suspected epileptogenic lesion that could cause focal NCSE, AD should be ruled out in elderly patients with progressive cognitive decline.

scholarly journals Recent classification of diabetes mellitus

2018 ◽  
pp. 52-57
Author(s):  
Kuldeep Tiwari ◽  
Dinesh Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Fundus Photography ◽  
Single Class ◽  
Adequate Treatment ◽  
Effective Prevention ◽  
Control Programmes ◽  
Recent Classification ◽  
The Right ◽  
Point Of Intersection ◽  
And Control

The right classification for diabetes mellitus (DM) allows a more adequate treatment and comprises four categories: type 1 DM, type 2 DM, other types, and gestational diabetes. Assigning a type of diabetes to an individual often depends on the circumstances present at the time of diagnosis, and many diabetic individuals do not easily fit into a single class. Diabetes mellitus and lesser forms of glucose intolerance, particularly impaired glucose tolerance, can now be found in almost every population in the world and epidemiological evidence suggests that, without effective prevention and control programmes, diabetes will likely continue to increase globally. These findings were confirmed in a similar study in India, in which the FPG and 2-h PG were each strongly and equally associated with retinopathy. For both the FPG and the 2-h PG, the prevalence of retinopathy was markedly higher above the point of intersection of the two components of the bimodal frequency distribution (FPG = 129 mg/dl [7.2 mmol/l] and 2- h PG = 207 mg/dl [11.5 mmol/l]). In the NHANES III, 2,821 individuals aged 40-74 years received an OGTT, a measurement of HbAlc, and an assessment of retinopathy by fundus photography.

scholarly journals Caso Clínico: Luxación Controlada de Cadera. Epifisiólisis de Cabeza Femoral

2018 ◽  
Vol 10 (2) ◽  
pp. 175-178
Author(s):  
Christian Romeo Bravo Aguilar ◽  
Franklin Xavier Bravo Aguilar ◽  
Adriana Abigail Guzmán Villa
Keyword(s):  
Femoral Head ◽  
High Body Mass Index ◽  
Long Term Results ◽  
Adequate Treatment ◽  
Surgical Dislocation ◽  
In Situ Fixation ◽  
Lancinating Pain ◽  
The Right ◽  
Dislocation Of The Hip

BACKGROUND: The epiphysiolysis of the femoral head is the displacement of the epiphysis with respect to the metaphysis, in anterosuperior direction; it is etiology is unknown, frequent in adolescents, peripubertal period, and with high body mass index, average age between 12 and 18 years. It is incidence is variable, 0.2 (Japan) to 10 (United States) per 100 000 inhabitants. It is characterized by progressive pain in the hip, with irradiation to the groin or knee, is associated with lameness; with the early detection, an adequate treatment can be established, the most accepted one is the in situ fixation with central screws. CASE REPORT: A 14-year-old female patient with no pathological history attended the Children's Orthopedic Service due to the chronic lancinating pain of the right hip, which increases with walking, it is diagnosed by clinical examination and complementary exams of femoral head epiphysiolysis. Surgical dislocation of the hip and anatomical open reduction with placement of spongy screws was performed. EVOLUTION: On the third day of surgery, hospital discharge is decided; walking with crutches and without support during a postoperative month. The osteosynthesis remained for a year with monthly controls and corresponding physiotherapy; it has been evidenced favorable evolution; hip mobility arches preserved, normal ambulation, without complications CONCLUSIONS: The initial treatment of a patient with epiphysiolysis of stable femoral head depends on the evolution time and is done by fixing with screws or needles with of anatomical dislocation of the hip and osteoplasty of femoral neck remodeling. Most patients do not develop necrosis or chondro- lysis and long-term results with in situ fixation are usually excellent, unlike patients with late diagnosis.

scholarly journals Status epilepticus during correction of hyponatremia in a patient with Alzheimer’s disease: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091541
Author(s):  
Ken Ichioka ◽  
Nobuhiro Akuzawa ◽  
Akio Takahashi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Case Report ◽  
Status Epilepticus ◽  
Synaptic Cleft ◽  
Sharp Waves ◽  
Old Japanese ◽  
Impaired Awareness ◽  
Clonic Seizures ◽  
The Right

An 83-year-old Japanese man with Alzheimer’s disease was admitted to our hospital for treatment of hyponatremia resulting from water intoxication. During hospitalization, the patient developed focal impaired awareness seizures, focal to bilateral tonic-clonic seizures, and subsequent status epilepticus. Electroencephalogram during focal impaired awareness seizures showed rhythmic 5–9 Hz theta activity in the right frontotemporal region. Electroencephalogram during focal to bilateral tonic-clonic seizures showed bilateral polyspikes. Electroencephalogram during an interseizure period revealed sharp waves in the right frontal region. Continuous intravenous administration of midazolam was the only effective treatment for status epilepticus. The patient died of aspiration pneumonia on day 58. Hyponatremia-associated status epilepticus is rare; in the present case, multifocal epileptogenicity resulting from Alzheimer’s disease and hyponatremia-associated elevation of glutamate levels in the synaptic cleft may have contributed to the onset of focal to bilateral tonic-clonic seizures with subsequent status epilepticus.

Blink-associated contralateral eccentric saccades as a rare sign of unilateral brain injury

Neurology ◽  
2016 ◽  
Vol 88 (2) ◽  
pp. 160-163 ◽  
Author(s):  
Ilaria Zivi ◽  
Eugenio Bertelli ◽  
Giacinta Bilotti ◽  
Ignazio Alessandro Clemente ◽  
Leopold Saltuari ◽  
...  
Keyword(s):  
Brain Injury ◽  
Evoked Potentials ◽  
Brain Mri ◽  
Neural Pathways ◽  
Cerebral Lesions ◽  
Infrared Video ◽  
Corrective Movement ◽  
The Right ◽  
Mri Study ◽  
Unilateral Brain

Objective:To describe a rare sign of unilateral brain injury as a form of unwanted blink-associated contralateral eccentric saccades.Methods:A 62-year-old patient who underwent an ischemic stroke affecting the entire right middle cerebral artery territory came to our attention 1 year after stroke, manifesting with transient contralateral conjugate gaze deviations associated with spontaneous blinking. We complemented the regular neurologic evaluation with brain MRI, study of evoked potentials, electroneurography of the facial nerve, and infrared video-oculoscopy.Results:The patient had left-sided hemiparesis, hypoesthesia, hemianopia, and hemispatial neglect. He also showed the occurrence of a rapid leftward conjugate deviation of the eyes, followed by a corrective movement to the primary ocular position. MRI showed a wide malacic area spanning the right frontal, temporal, and parietal cortical and subcortical regions, with signs of wallerian degeneration of the descending right corticospinal tract. Motor and somatosensory evoked potentials were centrally altered on the right side. Electroneurography of the facial nerves was normal. Infrared video-oculoscopy indicated persistence of the same blink-related saccades even in darkness.Conclusions:It is known that unilateral cerebral lesions may manifest with a contralateral conjugate gaze deviation evoked by closure of the lids. This sign, known as spasticity of conjugate gaze, may be due to the suppression of the fixation reflex. In our case, the persistence of this sign in the darkness allowed us to exclude this diagnosis. We hypothesized that the blink-related neural pathways may improperly activate the oculomotor circuitry at both the cortical and subcortical levels.

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