Presentation
Although the abnormal movement presented in our case has not been described before, our case should call for the attention of clinicians to the potential epileptic seizure. [dovepress.com]
Skip to content EPILEPSIA PARTIALIS CONTINUA: A RARE PRESENTATION OF HYPEROSMOLAR HYPERGLYCEMIC SYNDROME Pratikkumar Vekaria, MD, Ravish Patel, MD, Sumeer Tah, DO, Jeffrey Talbot, MD Case Presentation: A 42-year-old male with past medical history of morbid [shmabstracts.org]
Six patients presented hyperglycaemia at onset; this was positively correlated with TC (rho = 0.71). All 6 patients with hyperglycaemia presented a brain injury explaining the EPC episode. [elsevier.es]
EPILEPSIA PARTIALIS CONTINUA AS A MANIFESTATION OF HYPRGLYCEMIA-INDUCED MOVEMENT DISORDER Presentation Number: SAT-784 Date of Presentation: June 15th, 2013 Alejandra Borensztein * 1 and Helena Abby Guber 2 1 SUNY Downstate, New York, NY, 2 Brooklyn VA [endocrine.org]
[…] therapy presented with episodes of left-sided shaking and left gaze deviation with decreased level of consciousness. [najms.com]
Entire Body System
- Epilepsy
Epilepsy Behav. 2012 Jan;23(1):71-3. [PubMed: 22100067] [ncbi.nlm.nih.gov]
Liver, Gall & Pancreas
- Hepatosplenomegaly
On examination there was marked hepatosplenomegaly but no focal neurological deficit was evident. [jnnp.bmj.com]
Psychiatrical
- Suggestibility
Our report suggests that EPC can be due to mitochondrial respiratory chain disorders. Some clinical findings and initial investigations were indicative of a disorder of mitochondrial metabolism. [ncbi.nlm.nih.gov]
Often, seizures suggested multifocal origin within a limited cerebral region, with low-amplitude, irregular, asynchronous contractions that could resemble other movement disorders. [jamanetwork.com]
Neurologic
- Seizure
In exceptional cases jacksonian spread of the seizure ensues, which may even lead to a complex partial or secondarily generalized seizure. Sensory stimuli of any modality is known to modify the motor response in this type of seizure disorder. [jemds.com]
This phenomenon may be the reason for the localized nature of seizures seen in EPC compared to seizures arising from allocortex of the limbic pathways which is, by design, meant to spread excitation. [ncbi.nlm.nih.gov]
- Myoclonus
It has been argued that EPC is a form of focal cortical myoclonus, but sub–cortical mechanisms have also been proposed. [academic.oup.com]
Opsoclonus-myoclonus syndrome is a rare clinical condition that has been associated with neuroblastoma. [ncbi.nlm.nih.gov]
[…] origin of the myoclonus by neurophysiologic methods, a subcortical or even spinal origin of the myoclonus has to be considered. [neupsykey.com]
In some patients, cortical myoclonus occurred only in response to a variety of afferent inputs (cortical reflex myoclonus). [brain.oxfordjournals.org]
- Stroke
The aim was to prospectively ascertain its frequency 1 year after an ischaemic stroke. [ncbi.nlm.nih.gov]
The case above presents the rare and unfortunate combination of acute stroke and hyperglycemia as cause of EPC. [aesnet.org]
Stroke Stroke is generally recognized as a cause of EPC. -In one study, the frequency of EPC as a remote complication of anterior circulation ischaemic stroke is very low. [slideshare.net]
It often is a delayed complication of ischemic stroke with no established standard effective treatment. OBJECTIVE: We present two cases of EPC; one with remote history of ischemic stroke (IS) and the other in the setting of subacute IS stroke. [n.neurology.org]
- Focal Seizure
Conclusion EPC is a rare form of focal seizures. Although HHS is an uncommon cause of EPC, it needs to be considered in the differential diagnosis when a patient presents with continuous focal seizures. [pulmonarychronicles.com]
Epilepsia partialis continua (EPC) is characterized by focal seizures that cannot be stopped. The most common cause of EPC in children is Rasmussen's encephalitis. [indiana.pure.elsevier.com]
- Involuntary Movements
We describe a young Chinese patient with continuous involuntary movements of the contralateral hand affected by schizencephaly. [ncbi.nlm.nih.gov]
The involuntary movements stopped when euglycemia was reestablished. [pulmonarychronicles.com]
Workup
The diagnostic workup includes magnetic resonance imaging to clarify the etiology and EEG which typically shows focal epileptiform or slow wave activity but may vary from etiology to etiology. [ncbi.nlm.nih.gov]
EEG
- EEG Normal
Neurological and mental state Usually normal, depending on etiology. [epilepsy.com]
SEPs are normal, and C-reflex is absent. [clinicalgate.com]
- Burst Suppression on EEG
During this period of investigation his seizures could only be controlled initially on a thiopentone infusion at doses sufficient to cause burst suppression on EEG. [jnnp.bmj.com]
- EEG Seizure Activity
Seizure activity Slow; TW focal, multifocal or diffuse epileptic activity; seizures Slow; TWs TWs/θ→△ Periodic waves ↓Background TWs/θ→△ Periodic waves *Typical/cardinal features, TW: triphasic wave, Bold type indicates frequently cited clinical features [liveto.com]
- Multifocal Spikes
Inter-ictal multifocal spikes or sharp and slow waves in nearly all EEGs. Ictal EEG Epilepsia partialis continua is notorious with regard to lack of clinico-EEG correlations; epileptiform abnormalities may or may not be concomitant with the jerks. [epilepsy.com]
Treatment
It is indeed discouraging to know that our sophisticated investigation techniques and revolutionary treatment modalities have failed to tame this disorder. [jemds.com]
We calculated time to hospital admission (time to admission), time to assessment by the neurology department (time to neurological examination), time to treatment onset (time to treatment), and time from treatment onset to resolution of the episode (time [elsevier.es]
With the advent of high resolution MRI it is now often possible to identify areas of cortical dysplasia, increasing the possibility of neurosurgical intervention when seizures are refractory to medical treatment. [jnnp.bmj.com]
The treatment protocol for focal SE is not well defined and often leads to polypharmacy and additive side effects. [neurology.org]
Treatment options are limited and specific etiologies have to be taken into consideration, but EPC has shown to be resistant to antiepileptic drugs (AEDs). Hemispherectomy may be a treatment choice in patients with Rasmussen encephalitis. [ncbi.nlm.nih.gov]
Prognosis
KEYWORDS: epilepsia partialis continua; focal status epilepticus with motor symptoms; prognosis; recurrence; semiology [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]
Etiology
Etiology, clinical and EEG data, and outcome were categorized and analyzed. [ncbi.nlm.nih.gov]
Epidemiology
Pagina 67 - Socioeconomic characteristics of childhood seizure disorders in the New Haven area: an epidemiologic study Pagina 67 - Epilepsy after penetrating head injury. I. Clinical correlates: a report of the Vietnam Head Injury Study. [books.google.it]
Although no population-based epidemiological data are available, the prevalence of EPC is estimated to be lower than 1 case per 1 000 000 population in the United Kingdom, according to a clinical series published in the literature8; no data are available [elsevier.es]
Rasmussen encephalitis or chronic focal encephalitis (CFE), a rare neurological disease seen in children, has shown a strong association with EPC according to the current literature.[3] Epidemiology The incidence of epilepsia partialis continua (EPC) [ncbi.nlm.nih.gov]
Pathophysiology
The symptoms of EPC have been interpreted to be due to cortical hyperexcitability, but the exact pathophysiology is poorly understood due to a high degree of variability. [ncbi.nlm.nih.gov]
Prevention
The patient was counseled on appropriate diabetes management upon discharge to prevent Epilepsia Partialis Continua (EPS) in the future. [shmabstracts.org]
Overall, our results strongly indicate that a correct NCSE diagnosis is mandatory to prevent further deterioration in these patients. [ncbi.nlm.nih.gov]
Early antibiotic therapy for the typical skin lesion will often prevent the development of the more serious ]and long-lasting systemic illness. [medicinenet.com]
The cortex is endowed with powerful lateral inhibition, which prevents the spread of epileptogenic stimulus into surrounding regions. [jemds.com]