Complex partial seizure with postictal aggression as a presentation of atypical eclampsia: a case report

Background: Complex partial seizure with sudden onset in near term pregnancy can be challenging to the attending clinician and it is essential to proceed with a presumptive diagnosis of eclampsia, especially in resource poor settings. Unlike generalized tonic clonic seizures, which are more common in eclampsia, complex partial seizures may not jeopardize the fetus with the same severity. However the associated postictal aggression manifested in self-inflicted trauma poses an imminent risk onto the fetus. Case presentation: A nineteen year old gravida two para one living zero woman presented with seizure at thirty six weeks and three days of gestation in a district hospital. The blood pressure recordings during her entire pregnancy were normal and proteinuria was not present. Her previous pregnancy had a similar course, with self-inflicted trauma to her abdomen in a postictal state and resulted in loss of fetus. She did not have any seizures in between then and the current admission. While being managed in the labor ward, the family physicians witnessed complex partial seizure with postictal aggression. The delivery was expedited with caesarean section and she had no further seizure activity. Conclusion: Complex partial seizures with postictal aggression in pregnancy are rare but can be an atypical presentation of eclampsia and poses a diagnostic dilemma to the clinician.

Download Full-text

Mood Disorder, ‘Pre-ictal’ Psychosis and Temporal Lobe Damage

The British Journal of Psychiatry ◽

10.1192/bjp.157.3.441 ◽

1990 ◽

Vol 157 (3) ◽

pp. 441-444 ◽

Cited By ~ 2

Author(s):

Bankole A. Johnson ◽

Lachlan B. Campbell

Keyword(s):

Mood Disorder ◽

Temporal Lobe ◽

Clinical Manifestation ◽

Partial Seizure ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Simple Partial Seizure ◽

The Right

A patient with an abnormality in the right temporal lobe presented with episodes of mania many years before the clinical manifestation of both a simple partial seizure and complex partial seizures.

Download Full-text

Is Prolactin a Clinically Useful Measure of Epilepsy?

Epilepsy Currents ◽

10.1111/j.1535-7511.2006.00104.x ◽

2006 ◽

Vol 6 (3) ◽

pp. 78-79 ◽

Cited By ~ 3

Author(s):

Elinor Ben-Menachem

Keyword(s):

Status Epilepticus ◽

Elevated Serum ◽

Epileptic Seizures ◽

Complex Partial Seizure ◽

Class Ii ◽

Serum Prolactin ◽

Tilt Test ◽

Neonatal Seizures ◽

Partial Seizures ◽

Complex Partial Seizures

Use of Serum Prolactin in Diagnosing Epileptic Seizures: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Chen DK, So YT, Fisher RS Neurology 2005;65(5):668–675 (Review) Objective The purpose of this article is to review the use of serum prolactin assay in epileptic seizure diagnosis. Methods The authors identified relevant studies in multiple databases and reference lists. Studies that met inclusion criteria were summarized and rated for quality of evidence, and the results were analyzed and pooled where appropriate. Results Most studies used a serum prolactin of at least twice baseline value as abnormal. For the differentiation of epileptic seizures from psychogenic nonepileptic seizures, one Class I and seven Class II studies showed that elevated serum prolactin was highly predictive of either generalized tonic–clonic or complex partial seizures. Pooled sensitivity was higher for generalized tonic–clonic seizures (60.0%) than for complex partial seizures (46.1%), while the pooled specificity was similar for both (approximately 96%). Data were insufficient to establish validity for simple partial seizures. Two Class II studies were consistent in showing prolactin elevation after tilt-test–induced syncope. Inconclusive data exist regarding the value of serum prolactin following status epilepticus, repetitive seizures, and neonatal seizures. Recommendations Elevated serum prolactin assay, when measured in the appropriate clinical setting at 10 to 20 minutes after a suspected event, is a useful adjunct for the differentiation of generalized tonic–clonic or complex partial seizure from psychogenic nonepileptic seizure among adults and older children (Level B). Serum prolactin assay does not distinguish epileptic seizures from syncope (Level B). The use of serum PRL assay has not been established in the evaluation of status epilepticus, repetitive seizures, and neonatal seizures (Level U).

Download Full-text

A Study On Clinical Profile And Semiology In Complex Partial Seizures And Its Radiological Correlation

10.1101/2021.05.26.21257846 ◽

2021 ◽

Author(s):

Nandini Priyanka Balasubramani ◽

Elangovan S ◽

Thangaraj M

Keyword(s):

Temporal Lobe ◽

Medial Temporal Lobe ◽

Epileptic Seizures ◽

Complex Partial Seizure ◽

Febrile Seizures ◽

Cross Sectional Study ◽

Clinical Profile ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Cross Sectional

Background: Epilepsy is the second most common and frequently encountered neurological disorder which poses huge threat to known healthcare systems worldwide also causing financial, socio economic burden to the community. Complex Partial Seizures are a form of focal epileptic seizures that may impair consciousness. Aim and objectives: Our motivation for the study was to understand the extent of patients with complex partial seizures associated with medial temporal lobe sclerosis. Materials and methods: We performed a cross sectional study about patients with complex partial seizures in Thanjavur medical college and hospital about their clinical profile and neuro-radiological correlation. Statistical analysis and results: Through our multimodal study with EEG, MRI on N=118 (female / male, age range, Most common age group- 10-20 years, mean age of 23 years, SD- 14 years, 66% males), we observed that atypical febrile seizures and fever provoked seizures has more association (18%) to complex partial seizures and to medial temporal lobe sclerosis in comparison to 12% in an earlier study. Conclusion: We believe this study summarizes the complex partial seizure features, origin, and their link to Medial Temporal lobe Sclerosis in our subject pool from Thajavur, India. Limitation: There are some limitations to our study, especially with no video EEG monitoring and no invasive EEG recording. We aim to improve them in our future studies.

Download Full-text

Temporal choroidal fissure cyst and temporal lobe epilepsy: report of two cases

Journal of Epilepsy and Clinical Neurophysiology ◽

10.1590/s1676-26492010000400009 ◽

2010 ◽

Vol 16 (4) ◽

pp. 167-169 ◽

Cited By ~ 1

Author(s):

Gustavo Rassier Isolan ◽

Marino Muxfeldt Bianchin ◽

Carolina Machado Torres ◽

José Augusto Bragatti ◽

Juliana Bohn Assman ◽

...

Keyword(s):

Differential Diagnosis ◽

Temporal Lobe ◽

Clinical Course ◽

Case Reports ◽

Complex Partial Seizure ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Temporal Horn ◽

Background Data ◽

Temporal Lobe Seizure

STUDY DESIGN: Two case reports of a choroidal fissure cyst in the temporal horn associated with complex partial seizure. OBJECTIVES: To describe the clinical course, image findings and literature review of choroidal fissure cysts. SUMMARY AND BACKGROUND DATA: there are few reported cases of choroidal fissure cysts. RESULTS: We report two patients with complex partial seizures and temporal choroidal fissure cysts. The seizures were controlled in both patients. CONCLUSION: The choroidal fissure cyst diagnosis must highlight the importance of considering this lesion in the differential diagnosis of temporal lobe cyst and temporal lobe seizure.

Download Full-text

Partial Seizures, Etiologies and Associated Comorbidity Factors

Diyala Journal of Medicine ◽

10.26505/djm.19025320426 ◽

2020 ◽

Vol 19 (2) ◽

pp. 23-30

Author(s):

Mezher M Kadhim ◽

◽

Jalil I Kadhim ◽

Haitham H Basee ◽

Ammar A Mohammed ◽

...

Keyword(s):

Frontal Lobe ◽

Teaching Hospital ◽

Partial Seizure ◽

Parietal Lobe ◽

Brain Lesions ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Common Etiology ◽

A Prospective Study ◽

The Brain

Background: Partial seizure is well-defined as sudden extreme, profligate, and limited electrical discharges by gray matter from some portions of the brain due to certain structural & metabolic abnormalities. Objective: To distinguish the etiologies of partial seizures and to clarify its association with the age of affected patients. Patients and Methods: A prospective study, done on all patients with neurological consultation in Al- Batool Teaching Hospital, Baqubah Teaching Hospital and Al Yarmouk teaching Hospital from Nov, 2016 to Dec, 2018. Patients with partial seizures and/with secondary generalization were merged. This was fortified through a full history, physical checkup, EEG, and MRI of the brain. The study’s sample comprising 106 patients with partial seizures, the age ranged from 6-75 years, with 52 males and 54 females. Results: Atypical neuroimaging was found in (61%) of patients. Tumors occurred in (19.7%) of patients, the highest of them below 40 years of age while infarctions comprised 25.5% of patients outside this age. Complex partial seizures(CPS) patients with temporal lobe foci comprised 83.7 % and (16.2%) had frontal lobe problems, while (49%) of Simple partial seizures (SPS) patients had frontal lobe foci, 22% frontoparietal and 13% had parietal lobe foci and had brain lesions were spotted in 75.4% of patients with SPS and (35.1%) with complex partial seizures. Conclusion: Infarction is a common reason for partial seizures in patients above 40 years while below this age the tumor is common etiology. A partial seizure is connected mostly with brain lesions. Keywords: Partial seizures, comorbid factors, brain lesions

Download Full-text

SPECT in a Patient with Postictal PLEDs: Is Hyperperfusion Evidence of Electrical Seizure?

Clinical Electroencephalography ◽

10.1177/155005940203300407 ◽

2002 ◽

Vol 33 (4) ◽

pp. 171-173 ◽

Cited By ~ 21

Author(s):

Murat Fani Bozkurt ◽

Serap Saygi ◽

Belkis Erbas

Keyword(s):

Partial Seizure ◽

Brain Mri ◽

Epileptic Seizures ◽

Brain Perfusion ◽

Complex Partial Seizure ◽

Temporal Lobectomy ◽

Mesial Temporal Sclerosis ◽

Complex Partial Seizures ◽

Epileptiform Discharges ◽

The Right

The pathophysiological relation between periodic lateralized epileptiform discharges (PLEDs) and epileptic seizures is not known and the exact causative mechanism of PLEDs still remains unclear. In this report, the authors present a case in which the EEG displayed PLEDs after a complex partial seizure. This patient, with a long history of complex partial seizures, had previously undergone right standard anterior temporal lobectomy with hippocampectomy, with a diagnosis of mesial temporal sclerosis. She had one complex partial seizure 72 days after operation and was admitted to hospital. Her brain MRI revealed changes due to temporal lobectomy and small residual posterior hippocampic anomalies. PLEDs over the right temporal lobe were seen in postictal EEGs and persisted for 4 days despite the patient's normal mental status and normal neurologic examination. Brain perfusion scintigraphy with Tc-99m-HMPAO during PLEDs was performed on the second day after the seizure, and right temporal hyperperfusion was detected. EEGs and scintigraphic imaging were repeated after cessation of PLEDs. The repeated brain scan displayed right temporal hypoperfusion. PLEDs during the postictal period may actually be an ictal pattern, and if hyperperfusion in the brain SPECT studies during PLEDs is seen, further aggressive antiepileptic drug therapy may be necessary in some cases.

Download Full-text

Clinico-Demographic Characteristics and Different Diagnostic Findings of Epilepsy Patients in a Specialized Hospital Outside Dhaka in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v2i1.32954 ◽

2017 ◽

Vol 2 (1) ◽

pp. 3-9

Author(s):

Abdus Salam ◽

Md Ruhul Quddus ◽

Md Sayedur Rahman Sheikh ◽

Md Arshad-ul Azim ◽

Mohammad Enayet Hussain

Keyword(s):

Complex Partial Seizure ◽

Cross Sectional Study ◽

Demographic Characteristics ◽

Social Classes ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Cross Sectional ◽

Specialized Hospital ◽

Different Types ◽

Neurological Conditions

Background: Epilepsy is a common neurological conditions. It is a global problem affecting all ages, social classes, groups and countries. Objective: The purpose of the present study was to see the clinico-demographic characteristics and different diagnostic findings of epilepsy patients. Methodology: This cross sectional study was carried out in the Department of Neurology at Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh from November, 2012 to February, 2014. The patients were recruited from the epilepsy clinic. Clinical diagnosis of epilepsy was made by meticulous history and relevant clinical examination by the investigator. Routinely electroencephalography (EEG) was advised and interpreted by the investigator and MRI was advised in appropriate cases.Results: A total number of 115 epilepsy patients were recruited of which 77(67.0%) were male and 38(33.0%) were female. Most [95(83.7%)] of the patients were young (age group 0 to 29 years) and had partial seizures 89 (77.39%). Among these partial seizures most had complex partial seizure (CPS) [82(71.3%)] of which 53 (46.1%) had complex partial seizures-Temporal (CPS-T) and 29 (25.2%) had complex partialseizures-extra-temporal (CPS-ET) origin. EEG could be done in 76 patients. Among them 37(48.7%) had different types of abnormalities. MRI could be done in 52 patients and were found to be abnormal in 32(61.5%) patients.Conclusion: This study revealed that localization related epilepsy (LRE) is more common but the etiology remains undetermined in many cases. Therefore, more effort and investigation facilities are needed to identify the etiology. The high number of extra temporal lobe epilepsy (Ex-TLE) needs further evaluation in bigger sample.Journal of National Institute of Neurosciences Bangladesh, 2016;2(1): 3-9

Download Full-text

First Seizure While Driving (FSWD) — An Underestimated Phenomenon?

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100014633 ◽

2013 ◽

Vol 40 (4) ◽

pp. 540-545 ◽

Cited By ~ 5

Author(s):

Bernd Pohlmann-Eden ◽

Nina Hynick ◽

Karen Legg

Keyword(s):

Chart Review ◽

Clinical Presentation ◽

Retrospective Chart Review ◽

Complex Partial Seizure ◽

Partial Seizures ◽

Motor Tasks ◽

Complex Partial Seizures ◽

Visual Aura ◽

Drug Naïve ◽

Clonic Seizures

Abstract:Background:Seizures while driving are a well known occurrence in established epilepsy and have significant impact on driving privileges. There is no data available on patients who experience their first (diagnosed) seizure while driving (FSWD).Method:Out of 311 patients presenting to the Halifax First Seizure Clinic between 2008 and 2011, 158 patients met the criteria of a first seizure (FS) or drug-naïve, newly diagnosed epilepsy (NDE). A retrospective chart review was conducted. FSWD was evaluated for 1) prevalence, 2) clinical presentation, 3) coping strategies, and 4) length of time driving before seizure occurrence.Results:The prevalence of FSWD was 8.2%. All 13 patients experienced impaired consciousness. Eleven patients had generalized tonic-clonic seizures, one starting with a déjà-vu evolving to visual aura and a complex partial seizure; three directly from visual auras. Two patients had complex partial seizures, one starting with an autonomic seizure. In response to their seizure, patients reported they were i) able to actively stop the car (n=4, three had visual auras), ii) not able to stop the car resulting in accident (n=7), or iii) passenger was able to pull the car over (n=2). One accident was fatal to the other party. Twelve out of 13 patients had been driving for less than one hour.Discussion:FSWD is frequent and possibly underrecognized. FSWD often lead to accidents, which occur less if preceded by simple partial seizures. Pathophysiological mechanisms remain uncertain; it is still speculative if complex visuo-motor tasks required while driving play a role in this scenario.

Download Full-text