Although epilepsy-related violence can occur, accounts of criminal behavior caused by epilepsy remain rare and unconvincing. The authors describe a case of apparent postictal aggression, resulting in felony assault charges, by a patient who had nocturnal complex partial seizures, followed by what appeared to be sleepwalking and periods of postictal ...

A case of meningioangiomatosis occurring in a 15-year-old boy is reported. The patient did not show signs of neurofibromatosis on physical examination, and his medical history included only one previous episode of loss of consciousness, which was accompanied by a self-limited focal seizure. The lesion was associated with an oligodendroglioma ...

A 15-year-old boy with sequelae of perinatal asphyxia experienced intractable startle-induced epileptic seizures, which were transiently suppressed with episodic vomiting. His vomiting was associated with adrenocorticotropin and antidiuretic hormone discharge, and the alteration of urinary catecholamine excretion, which might modulate epileptic seizures. Because startle-induced epileptic seizures are resistant to conventional ...

The case of a 52-year-old man with an ataxicspastic syndrome associated with dystonia, faciobuccolingual dyskinesias and partial epileptic seizures is reported. Neurological imaging showed aspecific brain stem parenchymal alterations. Cerebellar biopsy revealed calcifications and the accumulation of perivascular acid mucopolysaccharides compatible with a diagnosis of "Calcinosis Nucleorum Cerebri", with the ...

Four autopsied cases of myoclonus, ataxia, and epilepsy from 2 separate pedigrees are described. An identical pattern of focal brainstem lesions was found in all the cases with selective and symmetrical degeneration of the dentate and second order somatosensory nuclei. The combined clinical and pathological features did not appear to ...

We report an infant who had successful epilepsy surgery for intractable infantile spasms in the setting of bilateral periventricular leukomalacia and remote germinal matrix hemorrhage. Although MRI gave evidence of a diffuse cerebral insult and EEG showed hypsarrhythmia, focal epileptogenicity was suggested by previous partial seizures with onset over the ...

Fronto-temporal dementia is a clinical syndrome with a number of pathological substrates, including frontal lobe degeneration, Pick's disease, and motor neuron disease with dementia; it also includes patients with a primary progressive language disorder. Twenty-four brains were examined, using immunohistochemistry for glial fibrillary acidic protein (GFAP) and ferritin. Five cases ...

In developed countries, the incidence of epilepsy is 50-100 cases per 100,000 population per year and the prevalence is approximately 5 to 8 cases per 1,000 population. Epilepsy is by far the most prevalent serious neurologic condition. Mortality rates in epilepsy are two to four times those found in matched ...

We report the first case of intravenous self-poisoning with Thiodan (30% endosulfan in xylene). A 28-year-old woman with a past history of epilepsy presented with refractory grand mal seizures after injecting 1 mL of Thiodan intravenously. She developed liver dysfunction, proximal myopathy secondary to rhabdomyolysis and renal failure. The seizures ...

We report the case of a patient with trisomy 21 (T21) with late onset epilepsy. The electroclinical features were of myoclonic jerks on awakening and generalised tonic clonic seizures, with generalised spike and wave on EEG, and a progressive dementia. As familial Alzheimer's dementia and progressive myoclonic epilepsy (Unverricht-Lundborg type) ...

Composition C-4 (C-4) is a plastic explosive widely used in both military and civilian settings. Ingestion of the active ingredient, RDX (cyclonite), can cause generalized seizures. Accidental and intentional C-4 (RDX) intoxications have occurred during manufacture or in wartime. In the literature the intentional ingestion of C-4 has been reported ...

Opercular malformations are rare and complex brain malformations for which only very fragmented neuropathological descriptions have been reported. They are related to an abnormal development of both sylvian fissure and frontoparietal operculum. We report a retrospective clinical and MRI study of 11 patients presenting with opercular malformations. A congenital pseudobulbar ...

A case of startle epilepsy, induced by an unexpected touch on the left shoulder of a 3.5 year old boy, was investigated. The startle epilepsy manifested as an atonic drop attack. Neurological examination revealed a mild hemiparesis on the left side. Computed tomography (CT) scanning demonstrated an enhancement over the ...

We undertook a prospective nationwide study to determine the incidence of photosensitive epilepsy (PE). Virtually all EEG departments in Great Britain (providing approximately 90% coverage of all EEGs performed on people with newly diagnosed seizures) screened cases referred to them over a 3 month period and identified all new cases ...

Spontaneous periodic hypothermia is a rare syndrome of recurrent, centrally mediated hypothermia without an identifiable systemic cause or brain lesion. Most patients defend a temporarily lowered temperature "set point" during episodes of hypothermia, despite manifesting many well-known systemic consequences of core temperature hypothermia. No case of death directly attributable to ...

This case report refers to a patient with PLEDs whose EEGs did not change while on steady levels of phenytoin and phenobarbital, but showed a complete disappearance of these discharges when felbamate was used. This report may serve to remind EEG'ers and epileptologists that the acute use of this drug ...

Lennox-Gastaut syndrome (LGS) is regarded as a model of the epileptic syndrome because of its specific clinicoelectrical manifestation. However, a close investigation reveals that its outline is somewhat vague, having the borderland around it. Precise diagnosis in an individual case is not always easy. In this paper, the diagnostic criteria ...

It has been demonstrated previously that performance on the modified Wisconsin Card Sorting Task (Nelson, 1976) is compromised by hippocampal sclerosis, particularly of the right hemisphere (Corcoran and Upton, 1993). Further evidence in support of this claim is presented here in the form of a case study. The findings from ...

We report the 3rd case in the literature of a 3-year-old boy with D-2-hydroxyglutaric (D-2-HG) aciduria, who presented primarily generalized hypotonia and feeding difficulty during the neonatal period, with eventual development of generalized myoclonic seizures. Gas chromatographic analysis of urinary organic acids showed persistent excretion of D-2-HG. The clinical manifestations ...

We report 3 cases of opercular myoclonic status epilepticus (OMASE), characterized by fluctuating cortical dysarthria without true aphasia associated with epileptic myoclonus involving bilaterally the glossopharyngeal musculature. In this syndrome, the inferior rolandic area of either one or the other hemisphere is involved by an epileptogenic lesion of various etiology. ...

A rare case of complex partial seizure (psychomotor epilepsy) with varying shades of psychiatric manifestations is presented. The highlights are multiplicity of its manifestation in the same case, its interchanging pattern and the variable durations. This gray area of psychiatry and neurology is discussed with special reference to diagnosis and ...

We review 160 cases of gliomatosis cerebri from the literature and report an additional three infants and young children who presented with intractable epilepsy, corticospinal tract deficits, and developmental delay in whom a pathologic diagnosis was made. The progressive nature of the encephalopathy in our cases was documented by serial ...

In dipole localization analysis many problems remain which affect the accuracy of localization. We performed dipole estimation of spikes and SEP components in identical patients. The subjects are 8 cases of benign childhood epilepsy with centrotemporal spikes (BCECS), and two cases of temporal lobe epilepsy (TLE). In 8 of 10 ...

We studied clinical and EEG features of 36 cases with congenital malformations of the CNS. Patients were followed at the outpatient clinic of Hospital Cayetano Heredia and of Hogar Clinica San Juan de Dios in Lima-Peru, from January 1984 to June 1992. Eighty percent of the patients had convulsive syndromes ...

Kevin suffered a severe Reye's encephalopathy at the age of 11 weeks which left him severely brain damaged. Simple partial seizures started in the recovery phase and were controlled by carbamazepine. He went on to develop symptomatic infantile spasms that were controlled by the addition of clonazepam. He became progressively ...

Epilepsy Expert is a decision support system based on the International Classification of Epilepsies and Epileptic Syndromes (1989). The aim of this study was to evaluate the Epilepsy Expert. First the diagnostic performance was validated. This was done in 3 stages: collection of the patient cases, determination of the 'correct ...

This review discusses the neuropathological issues pertaining to temporal lobectomies and neocortical resections for medically refractory seizures of childhood. Most cases in our pediatric series are "lesional" and have CT/MRI abnormalities that contribute to a higher incidence of "dual pathology" lesions rather than pure mesial temporal sclerosis. Almost up to ...

Propofol is a relatively new anesthetic agent used in outpatient surgery. Some investigators use it in the treatment of status epilepticus and in epilepsy surgery and have concluded that propofol has an anticonvulsant effect. Cases of seizure-like behaviors, myoclonus and opisthotonus following propofol anesthesia have been reported. Although rare, official ...

Long term exposure to organic solvents is usually not considered as a possible cause of chronic epileptic seizures. A case that shows a remarkable coincidence between exposure to organic solvents and occurrence of epileptic seizures is reported. The man was a 58 year old sign writer with lifelong exposure to ...

A 32-year-old man presented to the emergency department (ED) with seizures 6 hours after a lumbar myelogram with iopamidol (Isovue-M 200, Squibb, Princeton, NJ). Seizures are a rare complication after myelography with the current nonionic contrast agents and have not been previously reported in the emergency medicine literature. Emergency physicians ...

Hemimegalencephaly is a rare disorder manifest by early epilepsy, mental retardation and hemiplegia. The neuropathology has been described in only 15 cases to date. The present case provides a further description of the pathology in a hemispherectomy specimen and shows unusual features, including cystic breakdown of the white matter possibly ...

Patients who manifest neurologic deficits after a seizure can present an interesting challenge to emergency physicians, particularly when the deficits are not those normally associated with Todd's phenomenon. Although Todd's phenomenon is known to result in a wide variety of transient focal deficits, we find no case report in the ...

There is little experience with overdose of the relatively new antidepressant bupropion. The case of an 18-year-old healthy adult female patient after an intentional ingestion of 9 g of bupropion is presented. Her hospital course was significant for grand mal seizures, sinus tachycardia without conduction abnormality, and complete neurological recovery. ...

A case of congenital lipodystrophy complicated by complex-partial epilepsy is reported in a nine-year-old girl. The peculiarity of this rare case is represented by partial complex epilepsy with diffuse electroencephalographic alterations represented by a continuous seizure-like pattern that persisted unmodified despite the successful antiepileptic treatment. Although the etiopathology of lipodystrophy ...

Epilepsy is a major cause of morbidity and accounted for up to 40% of psychiatric outpatient attendances in the experience of the author in Transkei, South Africa. In many cases clinical diagnosis and management were easy. In this paper, the author analyses the clinical management problems presented by seven patients ...

Dilantin sodium is a commonly used anticonvulsive agent. A well-known side effect of this medication is hyperplasia of gingival tissues. This hyperplasia has also been reported in mucosa beneath complete dentures and has been related to poor oral hygiene. This case report describes hyperplasia of tissues around titanium implants in ...

The authors report a case of cerebral astrocytoma associated with a cavernous angioma. The patient presented with seizures and progressive hemiparesis. Diagnostic studies suggested the presence of a cavernous malformation with signs of previous haemorrhage. Surgery disclosed a complex tumour, which on histological examination revealed to be an anaplastic astrocytoma ...

We analyzed EEG characteristics comprehensively in a large series of nonconvulsive status epilepticus (NCSE) cases. Eighty-five ictal episodes in 78 patients were analyzed. The ictal discharges were generalized (group G) in 59 episodes (69%), diffuse with focal predominance (group GF) in 15 (18%), and focal (group F) in 11 (13%). ...

Witzelsucht and moria are time-honored neurobehavioral terms. Witzelsucht is a tendency to tell inappropriate jokes, and moria is euphoric behavior. Focal right-orbitofrontal parenchymal lesion is often the anatomical substrate for these behavioral attitudes. This case report presents a patient with a longstanding witzelsucht-moria behavior. Single photon emission computerized tomography (SPECT) ...

The authors review the relationship of repetitive behaviors to frontal lobe degenerations and report the repetitive and compulsive behaviors, radiologic imaging findings, and neuropathology of 3 patients with dementia secondary to frontal lobe degeneration. These 3 patients and 78% of 46 proven pathologic cases of frontal lobe degeneration described in ...

Pleomorphic xanthoastrocytoma (PXA) is a rare glial tumour typically occurring in young patients in the first three decades, having a superficial cortical location and with a relatively good prognosis for long-term survival. Four cases are reviewed. The magnetic resonance imaging (MRI) appearances, which in PXA have been reported only once ...

Methods for standardized classification of epileptic seizures are important for both clinical practice and epidemiologic research. In this study, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria. We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the ...

Epileptic nystagmus (EN) is a rare sign of seizure activity. We describe eight patients with horizontal EN and hypothesize that the frequency of ictal discharge, anatomic localization of ictal activity, and level of consciousness determine its occurrence and mechanism. We believe that EN is due to epileptic activation of a ...

This review looks at the magnetoencephalogram (MEG) studies on generalized epilepsy starting from the first cases investigated up to the most recent contributions regarding the photoconvulsive response and the results obtained applying the template analysis. As far as the spike-and-wave complex is concerned, in the cases both of photoconvulsive response ...

We reviewed six cases of proven or probable subacute necrotizing encephalomyelopathy with an onset under 12 months of age. All children had been investigated at the Adelaide Children's Hospital in the period 1975-90. Seizures (five of six) and cortical blindness (five of six) were more prominent clinical features at presentation ...

Acute cortical blindness as an ictal phenomenon has seldom been reported in the literature. The authors describe a seven-year-old boy who experienced several episodes of complete visual loss, accompanied by gastro-intestinal symptoms and a sensation of fright, but with preservation of consciousness. These episodes ended abruptly with visual recovery and ...

Ketotic hypoglycemia (KH) is recognized in the pediatric literature as the most common cause of childhood hypoglycemia. Since the first manifestation of the syndrome is classically that of new onset seizures, initial emergency department presentation is likely. We describe a representative case and emphasize the importance of routine serum glucose ...

We present a case of mild typical absences (phantom absences) culminating in absence status and generalized tonic-clonic seizures. The patient has recorded his experience during an episode of absence status and provides a rare insight into a mind temporarily clouded by whirling thoughts and muffled responses. This case is important ...

Craniosynostosis is a little known organic factor in sociopathy. This factor should be among those taken into consideration in selecting patients to undergo craniotomy. Among 22,000 skulls of neuropsychiatric patients, there were 100 with premature coronal synostosis, compared with 57 with dolichocephaly. Thirty-seven of the 100 patients with coronal synostosis ...

We report a 38-year-old woman with a mild form of hyperglycinemia complicated with optic nerve atrophy and convulsion. She was normal at birth and showed normal mental and physical development. After the age of 13, her visual acuity rapidly decreased. At the age of 33, she had numerous episodes of ...