scholarly journals Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect?

2021 ◽  
Vol 12 ◽  
Author(s):  
Konstantin L. Makridis ◽  
Sebastian Triller ◽  
Deniz A. Atalay ◽  
Christine Prager ◽  
Christian E. Elger ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Case Report ◽  
Behavioral Problems ◽  
Behavioral Disorder ◽  
Drug Discontinuation ◽  
Drug Resistant ◽  
Perinatal Stroke ◽  
Spontaneous Correction ◽  
Drug Resistant Epilepsy ◽  
Rule Out

Background: Hemispherotomy is an epilepsy surgery procedure applied to cure particularly pharmacorefractory lesional epilepsy due to unihemispheric pathologies. Such a disconnection of an entire hemisphere is followed by reorganizational processes.Methods: We describe an acute aggravation of behavioral problems following a hemispherotomy in a patient treated with valproic acid, which subsided once valproate was discontinued.Results: A 9-year-old boy with drug-resistant epilepsy caused by the residua of a perinatal stroke treated for several years with valproic acid and lamotrigine underwent hemispherotomy. Shortly after surgery, minimal preoperative behavioral problems intensified dramatically, and aggression occurred as a new symptom. Assuming a correlation between valproate treatment and the postoperative altered neuronal network, we tapered off valproate. The behavioral problems decreased in intensity with the reduction of valproate dose and disappeared after drug discontinuation.Conclusion: We describe severe behavioral problems after hemispherotomy that subsided when valproate was tapered off. While we cannot rule out a spontaneous correction of a post-hemispherotomy network dysregulation, our report raises awareness to possible altered effects of the anticonvulsant valproic acid parallel to reorganizational processes after hemispherotomy.

scholarly journals Diffuse Multifocal Bilateral Dysembryoplastic Neuroepithelial Tumor: A Very Unusual Case Report

2020 ◽  
Vol 7 (2) ◽  
pp. 109-112
Author(s):  
Hassan Reza Mohammadi ◽  
Ehsan Moradi ◽  
Elham Rahimian ◽  
Pascal Varlet ◽  
Yalda Nilipour
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Brain Cortex ◽  
Focal Epilepsy ◽  
Occipital Lobe ◽  
Behavioral Disorder ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Drug Resistant ◽  
Unusual Case Report

Dysembryoplastic neuroepithelial tumor (DNT) considered as a benign cortical glioneuronal neoplasm of children or young adults, typically present with drug-resistant focal epilepsy. DNTs are usually located in the temporal lobe but can found in any part of the supratentorial brain cortex. Multifocal DNTs have rarely reported. Here we present an eight years old boy with two years follow up, having a somewhat stable diffuse multinodular DNT of the most significant spatial extent that may have reported, involving cortical and subcortical left temporo-occipital lobe, bilateral basal ganglia and thalamus, presenting with headache, short stature, and behavioral disorder.

scholarly journals Dyke-Davidoff-Masson Syndrome: A case Report in a patient presenting with drug-resistant epilepsy and pseudoseizures

2021 ◽  
Author(s):  
Pedro Schmidt dos Reis Matos Figueiredo ◽  
Thiago Oliveira Chaves
Keyword(s):  
Case Report ◽  
Cognitive Dysfunction ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Drug Resistant ◽  
Cerebral Hemiatrophy ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Drug Resistant Epilepsy

Context: Dyke-Davidoff-Masson (DDM) syndrome is a rare neurological condition, first described in 1933. Characteristics include cerebral hemiatrophy, contralateral hemiparesis, seizures, and cognitive dysfunction, combined into different degrees and patterns. Brain magnetic resonance imaging (MRI) is used to perform diagnosis throughout its specific findings. Case Report: A eighteen-year-old female presented to our service with a history of cognitive dysfunction and seizures since early childhood, which persistence even with adequate use of antiepileptic drugs. During Investigation were found signs and symptoms compatible with DDM syndrome, and evidence of pseudoseizures captured in a video electroencephalography monitoring. Conclusion: DDM syndrome is a rare condition that must be part of differential diagnosis in patients with seizures and cerebral hemiatrophy. Management is based on adequate control of seizures and other comorbidities.

Epileptic Spasms Predict Poor Epilepsy Outcomes After Perinatal Stroke

2019 ◽  
Vol 34 (13) ◽  
pp. 830-836
Author(s):  
Jason P. Lockrow ◽  
Jason N. Wright ◽  
Russell P. Saneto ◽  
Catherine Amlie-Lefond
Keyword(s):  
Initial Response ◽  
Response To Treatment ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Perinatal Stroke ◽  
Epileptic Spasms ◽  
Venous Infarct ◽  
Structural Lesion ◽  
Drug Resistant Epilepsy ◽  
Severe Epilepsy

Perinatal stroke is a significant cause of severe epilepsy, including epileptic spasms. Although epileptic spasms due to underlying structural lesion often respond poorly to treatment and evolve into drug-resistant epilepsy, outcomes are not uniformly poor, and predictors of outcomes are not well described. We performed a single-institution retrospective review of epileptic spasms following perinatal stroke to determine if outcome depended on vascular subtype. We identified 24 children with epileptic spasms due to perinatal ischemic stroke: 11 cases of perinatal arterial stroke and 13 cases of perinatal venous infarct. Initial response to treatment was similar between groups; however, although children with perinatal arterial stroke who responded to epileptic spasms therapy had high rates of seizure freedom, many children with perinatal venous infarct, regardless of initial response, had residual drug-resistant epilepsy. We consider whether the mechanism for epileptogenesis may be different between arterial and venous strokes, and whether these 2 groups should be monitored for epileptic spasms, and subsequent epilepsy, differently.

scholarly journals Role of high-density EEG (hdEEG) in pre-surgical epilepsy evaluation in children: case report and review of the literature

2021 ◽  
Vol 37 (5) ◽  
pp. 1429-1437
Author(s):  
Michela Quintiliani ◽  
Federico Bianchi ◽  
Filomena Fuggetta ◽  
Daniela Pia Rosaria Chieffo ◽  
Antonia Ramaglia ◽  
...  
Keyword(s):  
Case Report ◽  
Low Cost ◽  
Previous History ◽  
Accurate Method ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Source Imaging ◽  
Left Hand ◽  
Negative Myoclonus ◽  
Drug Resistant Epilepsy

Abstract Introduction Electrical source imaging (ESI) and especially hdEEG represent a noninvasive, low cost and accurate method of localizing epileptic zone (EZ). Such capability can greatly increase seizure freedom rate in surgically treated drug resistant epilepsy cases. Furthermore, ESI might be important in intracranial record planning. Case report We report the case of a 15 years old boy suffering from drug resistant epilepsy with a previous history of DNET removal. The patient suffered from heterogeneous seizure semiology characterized by anesthesia and loss of tone in the left arm, twisting of the jaw to the left and dysarthria accompanied by daze; lightheadedness sometimes associated with headache and dizziness and at a relatively short time distance negative myoclonus involving the left hand. Clinical evidence poorly match scalp and video EEG monitoring thus requiring hdEEG recording followed by SEEG to define surgical target. Surgery was also guided by ECoG and obtained seizure freedom. Discussion ESI offers an excellent estimate of EZ, being hdEEG and intracranial recordings especially important in defining it. We analyzed our results together with the data from the literature showing how in children hdEEG might be even more crucial than in adults due to the heterogeneity in seizures phenomenology. The complexity of each case and the technical difficulties in dealing with children, stress even more the importance of a noninvasive tool for diagnosis. In fact, hdEEG not only guided in the presented case SEEG planning but may also in the future offer the possibility to replace it.

scholarly journals Seizure frequency can be reduced by changing intracranial pressure: A case report in drug-resistant epilepsy

2018 ◽  
Vol 10 ◽  
pp. 14-17 ◽  
Author(s):  
Daiki Uchida ◽  
Ayataka Fujimoto ◽  
Tomohiro Yamazoe ◽  
Takamichi Yamamoto ◽  
Hideo Enoki
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Seizure Frequency ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Low levels of valproic acid in patient undertaking ketogenic diet for drug-resistant epilepsy

2020 ◽  
Vol 40 ◽  
pp. 648
Author(s):  
E. Márquez Mesa ◽  
M. Perera Izquierdo ◽  
J.P. Suárez Llanos
Keyword(s):  
Valproic Acid ◽  
Ketogenic Diet ◽  
Drug Resistant ◽  
Low Levels ◽  
Drug Resistant Epilepsy
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