scholarly journals COVID-19 in Patients With Seizures and Epilepsy: Interpretation of Relevant Knowledge of Presenting Signs and Symptoms

2020 ◽  
Vol 20 (5) ◽  
pp. 312-315
Author(s):  
Robert Edward Hogan ◽  
Zachary Grinspan ◽  
Erika Axeen ◽  
Belinda Marquis ◽  
B. Keith Day

There are an increasing number of clinical studies for COVID-19, with several large cohort studies documenting initial signs and symptoms. Realizing the need for current information, this summary provides a focused summary of pertinent clinical diagnostic information about neurological involvement of SARS-CoV-2 virus and clinical presentation of COVID-19, especially in relationship to patients with seizures and epilepsy. There is no evidence from cohort studies in the general population that seizures are worsened in COVID-19. However, relative lack of cohort studies in patients with a history of epileptic seizures limit conclusions about effects of COVID-19 patients with epilepsy. Overall, findings indicate seizures and epilepsy are rare, especially in mild COVID-19 cases, but may occur in more severe cases later in the disease course. Caregivers should be vigilant in assessing for possible seizures, especially in patients with systemic effects of severe COVID-19 infections.

Author(s):  
Maneesha Sethi ◽  
Ridham Nanda ◽  
Amarjeet Singh Bali ◽  
P. Sadhotra

Background: Vernal Keratoconjunctivitis (VKC) is common cause of ocular morbidity in children living in tropical countries. Its diagnosis is based on signs and symptoms of the disease. The study was undertaken to stress upon the demography and clinical presentation of VKC.Methods: Retrospective pre-formed proforma of 155 patients of VKC, who were detected at random in the out - patient department of ophthalmology, ASCOMS, Jammu from May 2016 to April 2017, were analyzed.Results: Mean age at presentation was 10.31 years +4.05. The Male: Female ratio was 4.96:1. Majority of patients reported in the month of May. Mixed type of VKC was predominant. Personal or family history of allergy was seen in 5.8% of patients. Itching (100%) was commonest symptom and palpaberal papillae were commonest sign seen in 78.70% of patients.Conclusions: Clinical pattern of VKC seen in hot and dry climate of Northern India is like that seen in other parts of country.


2020 ◽  
Vol 15 (2) ◽  
pp. 12-16
Author(s):  
A. S. Kotov

Objective: to study the structure of the disease and develop tactics of treatment of patients with single and rare epileptic seizures. Materials and methods. 1200 patients with epilepsy were examined, 103 patients were identified who had no more than 3 seizures throughout their life. Study included evaluation of anamnesis, clinical and neurological examination, routine electroencephalography and/or videoelectroencephalographic monitoring, magnetic resonance imaging of the brain. Results. Relapse of seizures in individuals with a history of follow-up occurred in 32 % of cases; epileptogenic changes in magnetic resonance image and, especially, anatomical and electro-clinical correlation of the epilepsy focus were associated with the risk of relapse. Conclusions. The decision on drug therapy after the first unprovoked seizure should be based on the ratio of the risk of repeated seizures and the risk of side effects. This solution should be individual and take into account not only medical problems, but also the preferences of the patient and his family members.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Jithma P. Abeykoon ◽  
Narjust Duma ◽  
Jennifer A. Tracy ◽  
Margherita Milone ◽  
Ronald Go

A 70-year-old female presented with a three-year history of evolving macroglossia causing dysphagia and dysarthria, with proximal muscle weakness. Given the classic physical finding of macroglossia, the patient underwent extensive evaluation for amyloidosis which proved to be negative apart from a bone marrow biopsy which stained positive for transthyretin without amino acid sequence abnormality, thus giving wild-type transthyretin amyloidosis. Since the wild-type transthyretin amyloidosis could not entirely explain her clinical presentation and evaluation, further studies were conducted in a sequential manner, thus leading to a diagnosis of Pompe disease explaining her presenting signs and symptoms including her macroglossia. Through this fascinating case, we attempt to highlight the approach for the diagnoses of two rare diseases in a patient by emphasizing the importance of having a broad differential diagnosis when presented with findings which may have been thought as pathognomonic for certain diseases.


2021 ◽  
Author(s):  
Muaz.A.Ibrahim ◽  
Tasneem.M.F ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Abdallah M. Abdallah ◽  
Mohammed Eltahier Abdalla Omer ◽  
...  

Abstract Background: Epilepsy is one of the most common neurological diseases. The coexistence of epilepsy and PNES poses a major challenge to neurologists and psychiatrists in the treatment and follow-up care of patients. Methods: 33 Sudanese patients with epilepsy and concomitant psychogenic non epileptic seizure where included in this study and full detailed history of both epilepsy and PNES was obtained. The study was conducted in Daoud charity clinic during the period from May to July 2018Results : Out of 33 patients 19 were males and 14 were females. Seven patients had focal epilepsy, 23 had generalized tonic clonic epilepsy (GTC), 2 had GTC with atypical absent seizure, and one had GTC with myoclonus.Six patients experienced an attack of PNES after more than 1 year of being free of epilepsy, while 9 patients had PNES attack between 3 months to 1 year of the last attack of epilepsy, and 18 patients developed both PNES and epilepsy within less than 3 months.The pattern of presentation of PNES was bizarre movements in 13 patients, abnormal behavior in 9 patients, while 11 patients experienced both bizarre movement and abnormal behavior note that all those 11 patients had GTC epilepsy. Conclusion: Experiencing psychogenic non epileptic seizure (PNES) in patients with coexisting PNES and epilepsy is not affected by the epilepsy free period


Psychogenic non-epileptiform seizures (PNES) are a common condition that affects over 400,000 individuals within the United States. PNES are a challenging entity in modern medicine, for they are located at the interface between neurology and psychiatry regarding clinical presentation and pathophysiology. The experiences and symptomatology of the patients resemble those associated with epileptic seizure activity, however many patients present with co-occurring psychiatric comorbidity. A combination of video-electroencephalography and a concise, welldocumented clinical history of the event helps in a definitive clinical diagnosis of PNES. Measuring the levels of serum prolactin may prove useful as an adjunctive laboratory test in diagnosing PNES. Management of PNES involves prompt patient education regarding the condition and treating the psychiatric comorbidity as well. A combined approach of both psychotherapeutic and pharmacological interventions helps in the optimal treatment of PNES.


2018 ◽  
Vol 25 (2) ◽  
pp. e1-e11 ◽  
Author(s):  
Shaik Afshan Jabeen ◽  
Padmaja Gaddamanugu ◽  
Ajith Cherian ◽  
Kandadai Rukmini Mridula ◽  
Dasari Uday Kumar ◽  
...  

Objectives To study the clinical profile and outcome in patients with epilepsy who developed psychogenic non-epileptic seizures (PNES) associated with levetiracetam (LEV) use. Methods In this prospective observational study, conducted over 1 year, 13 patients with epilepsy and PNES, documented by video electroencephalogram (VEEG) while on LEV, were included. Those with past history of psychiatric illnesses were excluded. VEEG, high-resolution magnetic resonance imaging, neuropsychological and psychiatric evaluation were performed. Patients in Group I (07) were treated with psychotherapy, psychiatric medications and immediate withdrawal of LEV while, those in Group II (06) received psychotherapy, anxiolytics and LEV for initial 2 months after which it was stopped. Follow-up period was six months. Results Mean (±SD) age of patients was 25 ± 12.28 years; there were 11 (84.62%) females. All were on antiepileptic agents which included LEV >1000 mg/day, except one. Mean dose of LEV was 1269.23 ± 483.71 mg/day. Three patient’s scores were suggestive of depression or anxiety; one had both depression and anxiety. Eight patients had mood disorders; three had a history of emotional abuse or neglect. PNES subsided in all patients within 1–3 months, only after withdrawal of LEV and did not recur in any after stopping LEV. Conclusion LEV can induce PNES in susceptible populations. Awareness of this association is crucial for timely withdrawal of triggering factor and appropriate management. This will reduce inadvertent additional prescription of antiepileptic agents.


Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. E1332-E1333 ◽  
Author(s):  
Nur Altinörs ◽  
Tarkan Calisaneller ◽  
Salih Gülşen ◽  
Özlem Özen ◽  
Önder Öngürü

Abstract OBJECTIVE The most common localization of dysembryoplastic neuroepithelial tumors (DNTs) is the supratentorial cortex, often in the temporal lobe. However, intraventricular localization of a DNT is extremely rare. CLINICAL PRESENTATION A 30-year-old woman presented with a 1-year history of epileptic seizures. The seizures had not been controlled despite standard doses of antiepileptics. INTERVENTION Neuroimaging results demonstrated a lesion located in the occipital horn of the right lateral ventricle. The lesion was totally removed. Based on histopathological and immunohistochemical evaluation, a DNT was diagnosed. Over the course of the next 8 months, the patient's epileptic seizures were under control. The most recent neuroimaging examinations revealed neither residual nor recurrent tumor. CONCLUSION Because DNTs are surgically curable and neither radiotherapy nor chemotherapy is required after surgery, recognition of an intraventricular DNT in this location is extremely important.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Valentina Arnao ◽  
Marianna Riolo ◽  
Brigida Fierro ◽  
Paolo Aridon

We describe a case of epileptic seizures occurring after the use of a COX-2 inhibitor. A 61-year-old man was admitted to our department because of a generalized tonic-clonic seizure. EEG showed generalized slowdown of the activity. Neuroimaging and blood samples studies did not evidence alterations, but a careful pharmacological history revealed that the patient had taken the COX-2 inhibitor etoricoxib to treat lumbago few days before the onset of clinical symptoms. No seizures were reported after etoricoxib discontinuation and an EEG resulted to be normal two months after this. Conclusion. Knowing the pharmacological history of a patient is important for understanding the clinical presentation and selecting appropriate treatment. This is, to the best of our knowledge, the first reported case of generalized seizures associated with the use of COX-2 inhibitors.


2017 ◽  
Vol 8 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Kei Murao ◽  
Shuji Arakawa ◽  
Yoshihiko Furuta ◽  
Masahiro Shijo ◽  
Tetsuro Ago ◽  
...  

Cerebral venous thrombosis (CVT) has a broad spectrum of clinical presentation compared to arterial etiology. Seizure is one of the common symptoms and is more frequent than in other stroke types. Hence, transient neurological symptoms in CVT patients are usually due to epileptic seizures, while transient repetitive movement disorder is extremely rare except as a complication of epilepsy. We report a case of CVT in the superior sagittal sinus with a 1-year history of paroxysmal kinetic tremor without evident epilepsy.


2019 ◽  
Author(s):  
Luigi Petramala ◽  
Valeria Bisogni ◽  
Federica Olmati ◽  
Antonio Concistrè ◽  
Monia Celi ◽  
...  

Abstract Background Although PGLs may arise at any site where physiologic paraganglionic tissue exists, pelvic origins are not frequent (about 2%), and the most common localization is the retroperitoneal space, whereas bladder PGLs account for less than 0.06% of all bladder neoplasms and less than 1% of all PGLs. Starting from the description of two interesting our cases, we wondered to review the literature on pelvic and bladder paragangliomas (PGLs) with the aim of illustrating clinical characteristics and current management, and enlightening the needed of a prompt diagnosis to avoid the onset of several complications.Methods We herein performed a brief review of the literature about pelvic PGLs in the PubMed library, conducted according to the PRISMA statement, including studies published from 1954 to 2019. We also discuss clinical presentation, morphologic appearance, and management of two cases of pelvic PGL, both of them characterized by a history of paroxysmal high blood pressure episodes uncontrolled by antihypertensive therapy associated with disabling symptoms, misdiagnosed for many years.Results Overall, we evaluated 108 case reports. The majority were females, presenting typical signs and symptoms, such as arterial hypertension (54.2%), hematuria (35.1%), and headache (33.6%). After treatment, the clinical and biochemical remission was showed in only 55% of analyzed cases.Conclusions For their singular localization, pelvic and bladder PGLs often might be misdiagnosed. The resulting delay in the proper treatment could be responsible for the relative low percentage of complete clinical and biochemical remission.


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