scholarly journals Atypical Presentation Of Paediatric Absence Seizure: EEG As A Diagnostic Tool

2021 ◽  
Vol 10 (1) ◽  
pp. 76-78
Author(s):  
R. KC ◽  
R. Poudel
Keyword(s):  
Sodium Valproate ◽  
Clinical Examination ◽  
Diagnostic Tool ◽  
Absence Seizure ◽  
Atypical Presentation ◽  
Absence Seizures ◽  
Detailed History ◽  
Atypical Presentations

Absence seizures involve brief, sudden lapses of consciousness and are more common in children than in adults. We report a case of absence seizure in a girl with atypical presentation which was diagnosed by electroencephalogram. She responded well to sodium valproate. Detailed history, clinical examination and use of electroencephalogram for diagnosis is necessary especially when such atypical presentations are encountered.

scholarly journals Atypical EEG pattern in children with absence seizures

1995 ◽  
Vol 53 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Délrio F. Silva ◽  
Márcia Marques Lima ◽  
Renato Anghinah ◽  
Edmar Zanoteli ◽  
José Geraldo Camargo Lima
Keyword(s):  
Absence Seizure ◽  
Complete Control ◽  
Absence Seizures ◽  
Normal Finding ◽  
Delta Activity ◽  
Eeg Changes ◽  
Eeg Pattern

We studied four children with diagnosis of absence seizures (generalized primary epilepsy), and with a generalized delta activity on the EEG during clinical attacks provoked by hyperventilation. The lack of ictal generalized spike-and-wave discharges with a frequency of 3 Hz in our patients, makes this an atypical pattern. All children had complete control of their seizures and disappearance of the EEG changes with valproate. We concluded that generalized delta activity observed on EEG during the hyperventilation in children should not always be considered as a normal finding for age, since it could be an ictal event of an absence seizure.

scholarly journals Challenges in the Diagnosis of Giant Cell Arteritis Before Visual Loss

2020 ◽  
pp. 1-5
Author(s):  
Purnima Mehta ◽  
Faaiq Hassan ◽  
Muhammed Omar Qadir ◽  
Shirish Dubey ◽  
Sergio Pagliarini ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
Common Type ◽  
Atypical Presentation ◽  
Delay In Diagnosis ◽  
Atypical Presentations ◽  
High Index Of Suspicion

Background: Giant cell arteritis (GCA) is the most common type of systemic vasculitis affecting the elderly. Ophthalmic presentations of GCA in particular can be difficult to identify prior to permanent visual loss occurring. Methods: Here, we present 3 challenging cases as a retrospective series to highlight the variable presentations of GCA with ophthalmic involvement, but GCA was not suspected due to atypical presentation. Results: Unfortunately, all 3 cases went on to develop visual loss in the affected eye due to a delay in diagnosis or treatment. The authors wish to highlight the challenges posed to the referring clinicians, when patients had systemic/ocular co-morbidities, which delayed the suspicion of GCA Conclusion with a Practical Point: Our cases highlight the variable presentations of this condition as well as the devastating ophthalmic implications that GCA can have. A high index of suspicion must be maintained; particularly in elderly patients with atypical presentations.

scholarly journals Incidence of mortality due to malaria with typical and atypical presentation

2018 ◽  
Vol 5 (4) ◽  
pp. 818
Author(s):  
Shital N. Rathod ◽  
Arvind Chavan ◽  
Shilpa Sharma ◽  
Tushar Rathod ◽  
Koustubh Bavdhankar
Keyword(s):  
Mortality Rate ◽  
Falciparum Malaria ◽  
Age Groups ◽  
Clinical Suspicion ◽  
Study Group ◽  
Atypical Presentation ◽  
Peripheral Smear ◽  
Atypical Presentations ◽  
High Index Of Suspicion ◽  
Mixed Infestation

Background: Malaria, despite intensive efforts to control, remains a leading cause of morbidity and mortality in humans. India contributes to 61 per cent of malaria cases and 41 per cent of malaria deaths in SEAR countries. The objective of the present study was to find out an incidence of mortality due to malaria with typical and atypical presentation.Methods: The present was conducted over a period of three years. During the study period 630 patients with clinical suspicion of malaria were tested for malaria using peripheral smear, QBC and RDT.Results: The mortality rate in this study group 161 (25.55%) out of which maximum mortality observed in patients with falciparum malaria either singly or with mixed infestation. There is no significant correlation between the typical and atypical presentations in the different age groups with mortality.Conclusions: For timely diagnosis and treatment a high index of suspicion for the disease should be maintained by treating physicians, especially in endemic areas. They should be aware of the varied manifestations to minimize the mortality due to malaria.

Atypical presentation of rapid-onset dystonia–parkinsonism in a toddler with a novel mutation in the ATP1A3 gene

2021 ◽  
Vol 14 (8) ◽  
pp. e244152
Author(s):  
Aishwarya Ganesh ◽  
Samyuktha Sivakumar ◽  
RanjithKumar Manokaran ◽  
Udayakumar Narasimhan
Keyword(s):  
Novel Mutation ◽  
Gene Mutations ◽  
Paediatric Population ◽  
Rapid Onset ◽  
Lower Limbs ◽  
Muscle Rigidity ◽  
Atypical Presentation ◽  
Genetic Sequencing ◽  
Atypical Presentations ◽  
Atp1a3 Gene

ATP1A3 gene mutations can result in a spectrum of diseases with diverse neurological manifestations. One such disorder linked to this mutation is rapid-onset dystonia–parkinsonism (RDP), which manifests as dystonia with features of parkinsonism, such as tremors, rigidity, muscle spasms, and bulbar symptoms. Affected patients are typically adolescents or young adults, with symptoms occurring in a rostrocaudal pattern. We report a unique case of a 2-year-old child with an early onset, atypical presentation of RDP. In addition to motor developmental delay, he presented with muscle rigidity and mild asymmetric dystonia of the limbs, with the lower limbs being more affected than the upper limbs. Genetic sequencing of the child revealed a novel heterozygous autosomal dominant mutation of ATP1A3 gene c.173A>G (p. Tyr58Cys). This report highlights that RDP can present with atypical presentations in the paediatric population and adds to existing medical literature on the clinical spectrum of ATP1A3 genetic channelopathy.

scholarly journals Cortical Tonic Inhibition Regulates the Expression of Spike-and-Wave Discharges Associated with Absence Epilepsy

2017 ◽  
Author(s):  
Kile P. Mangan ◽  
Aaron B. Nelson ◽  
Steven Petrou ◽  
Chiara Cirelli ◽  
Mathew V. Jones
Keyword(s):  
Absence Epilepsy ◽  
Tonic Inhibition ◽  
Absence Seizure ◽  
Optimum Level ◽  
Normal Functioning ◽  
Absence Seizures ◽  
Pharmacological Blockade ◽  
Eeg Recordings ◽  
Wave Discharge ◽  
Video Eeg

ABSTRACTSynchronous and bilateral spike-and-wave discharges accompany nonconvulsive behavioral and cognitive arrest during seizures associated with absence epilepsy. Previous investigation of multiple absence animal models suggests that the underlying cause of absence seizures is an increase in thalamic inhibitory tonic currents. In contrast, in this study we provide evidence that the level of cortical tonic inhibition also regulates absence seizure expression. Using continuous video-EEG recordings to monitor absence seizures and spike-and-wave discharge expression we show that pharmacological blockade of cortical tonic inhibition provokes absence seizures in wild-type mice. Furthermore, we show that pharmacological rescue of cortical tonic inhibition in an absence mouse (γ2R43Q) model, which lacks tonic inhibition, suppresses absence seizure and spike-and-wave discharge expression. Collectively, these results suggest an optimum level of tonic inhibition in the thalamocortical circuit is required for normal functioning and that a deviation from this optimum results in aberrant thalamocortical function, SWDs and absence seizures.

scholarly journals Seizure in children: How important is EEG & Neuroimaging?

2021 ◽  
Vol 11 (2) ◽  
pp. 253-257
Author(s):  
Sunil Kumar Agarwalla
Keyword(s):  
Clinical Examination ◽  
Age Groups ◽  
Careful Examination ◽  
Seizure Type ◽  
Age Group ◽  
Unprovoked Seizure ◽  
Female Ratio ◽  
Detailed History ◽  
Eeg Data ◽  
Magnetic Resonance Imaging Mri

Seizure in children are generally indicating a potentially serious underlying systemic or CNS disorders that require thorough clinical examination, investigation and management. It is therefore important to establish accurate diagnosis of seizure and its etiology to manage such patients appropriately. We carried out this study to evaluate different etiology of seizures and its correlation with abnormal EEG & abnormal neuroimaging in the age group of 2mo to 14 years. 200 children presented with seizure to our department from January 2019 to November 2020 were enrolled in this prospective hospital-based study. Detailed history, clinical examination, investigation with special emphasis to EEG & neuroimaging was done and different correlation was drawn by using SSPS 18.0 statistical analysis. Among 200 cases, 6 to 10yr. age group constituted maximum (49%) number of cases. Male to female ratio is 1.5:1. GTCS is the predominant pattern of seizure (60%) in all age groups. EEG abnormality is found in 45%, mostly in focal seizure type. Neuroimaging abnormality found in 29%. Maximum cases (30%) had infectious etiology. Childhood seizure needs detailed history taking and careful examination. Vedio recording shown by parents / caregivers really help towards differentiating seizure from seizure mimics. EEG has a role in specific seizure type; Neuroimaging at times helps in diagnosis. There are few studies that describe neuroimaging [Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)] and Electroencephalogram (EEG) data in children who present with new-onset seizures. The EEG is recommended as a part of the neurodiagnostic evaluation of the child with an apparent first unprovoked seizure.

scholarly journals Primary Amenorrhoea - A review of 26 Cases

2016 ◽  
Vol 20 (3) ◽  
Author(s):  
Farhat Iqbal ◽  
Naheed I
Keyword(s):  
Abdominal Pain ◽  
Clinical Examination ◽  
Lower Abdominal Pain ◽  
Imperforate Hymen ◽  
Detailed History ◽  
Primary Amenorrhoea ◽  
Secondary Sex Characters

This is a study of twenty six subjects who presented to Sir Ganga Ram Hospital, Lahore 1999-2001 and were cases of primary amenorrhoea 20(76.9%) of patient presented between 15-25 years of age. Five (19.2%) had lower abdominal pain. Secondary sex characters were developed in 69.2%. Uterus was absent in 4(15.5%) and ovaries were present in 17(65.5%). FSH was high >40mIU in 12(46.5%) and low <3mIU in 2(7%), 14(53.5%) were put on HRT 1(3.8%) had gonadectomy. 5(19.3%) patients had imperforate hymen, where excision was done. It was concluded that detailed history, through clinical examination and minimal investigations are required to diagnose cases of primary amenorrhoea.

scholarly journals Chemogenetic Activation of Feed-Forward Inhibitory Parvalbumin-Expressing Interneurons in the Cortico-Thalamocortical Network During Absence Seizures

2021 ◽  
Vol 15 ◽  
Author(s):  
Sandesh Panthi ◽  
Beulah Leitch
Keyword(s):  
Absence Epilepsy ◽  
Designer Drug ◽  
Absence Seizure ◽  
Absence Seizures ◽  
Feed Forward ◽  
Video Recordings ◽  
Intraperitoneal Dose ◽  
Spike Wave Discharges ◽  
The Impact

Parvalbumin-expressing (PV+) interneurons are a subset of GABAergic inhibitory interneurons that mediate feed-forward inhibition (FFI) within the cortico-thalamocortical (CTC) network of the brain. The CTC network is a reciprocal loop with connections between cortex and thalamus. FFI PV+ interneurons control the firing of principal excitatory neurons within the CTC network and prevent runaway excitation. Studies have shown that generalized spike-wave discharges (SWDs), the hallmark of absence seizures on electroencephalogram (EEG), originate within the CTC network. In the stargazer mouse model of absence epilepsy, reduced FFI is believed to contribute to absence seizure genesis as there is a specific loss of excitatory α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) at synaptic inputs to PV+ interneurons within the CTC network. However, the degree to which this deficit is directly related to seizure generation has not yet been established. Using chemogenetics and in vivo EEG recording, we recently demonstrated that functional silencing of PV+ interneurons in either the somatosensory cortex (SScortex) or the reticular thalamic nucleus (RTN) is sufficient to generate absence-SWDs. Here, we used the same approach to assess whether activating PV+ FFI interneurons within the CTC network during absence seizures would prevent or reduce seizures. To target these interneurons, mice expressing Cre recombinase in PV+ interneurons (PV-Cre) were bred with mice expressing excitatory Gq-DREADD (hM3Dq-flox) receptors. An intraperitoneal dose of pro-epileptic chemical pentylenetetrazol (PTZ) was used to induce absence seizure. The impact of activation of FFI PV+ interneurons during seizures was tested by focal injection of the “designer drug” clozapine N-oxide (CNO) into either the SScortex or the RTN thalamus. Seizures were assessed in PVCre/Gq-DREADD animals using EEG/video recordings. Overall, DREADD-mediated activation of PV+ interneurons provided anti-epileptic effects against PTZ-induced seizures. CNO activation of FFI either prevented PTZ-induced absence seizures or suppressed their severity. Furthermore, PTZ-induced tonic-clonic seizures were also reduced in severity by activation of FFI PV+ interneurons. In contrast, administration of CNO to non-DREADD wild-type control animals did not afford any protection against PTZ-induced seizures. These data demonstrate that FFI PV+ interneurons within CTC microcircuits could be a potential therapeutic target for anti-absence seizure treatment in some patients.

scholarly journals Clinical study of right iliac fossa mass: experience at a rural hospital

2018 ◽  
Vol 5 (6) ◽  
pp. 2308
Author(s):  
Harshal B. Ramteke ◽  
Harmandeep Singh ◽  
Dhirendra D. Wagh ◽  
Rohini J. Bhoyar
Keyword(s):  
Clinical Examination ◽  
Psoas Abscess ◽  
Iliac Fossa ◽  
Rural Hospital ◽  
Pathological Diagnosis ◽  
Interval Appendectomy ◽  
Common Cause ◽  
Detailed History ◽  
Mass Formation ◽  
Appendicular Mass

Background: Objectives of present study was to study the clinical profile, different modalities of investigation and various modes of management for Right Iliac Fossa (RIF) mass at a rural hospital, A.V.B.R.H.Methods: Total 86 cases of RIF mass were studied prospectively for 4 years from August 2013 to September 2017. Patients above the age of 10 years presenting with a mass in RIF associated with acute/chronic abdominal conditions and incidentaly found mass in RIF on examination and investigation were included in the study. Patients with abdominal wall/bony swellings of the region and gynaecological causes of RIF mass were excluded. After detailed history and clinical examination, patients were subjected for different investigations to establish pathological diagnosis and treated accordingly.Results: 69.76% cases with RIF mass were related to appendicular pathology. Of these 60.48% were appendicular mass and 9.3% were appendicular abscess. 13.95% cases were Carcinoma Caecum, 6.97% cases were Ileo-caecal Tuberculosis, 6.97% were of ilio-psoas abscess and 2.32% cases were of Intusussception. Mean age of RIF mass was 37.41 years with a male preponderence of 1.4:1. Pain in abdomen was the commonest symptom. 16.28%(14) cases were treated conservatively and 83.72%(72) were treated surgically.Conclusions: Most common cause of RIF mass is appendicular lump (60.46%) among various other pathologies. Pain in abdomen is the commonest presenting symptom. Interval appendectomy should be considered essential as the incidence of recurrence of appendicitis and mass formation is high after conservative treatment. Detailed history and thorough clinical examination is of utmost importance to reach the correct clinico-pathological diagnosis of RIF mass. 

Sign in / Sign up

Export Citation Format

Share Document