1/10. Childhood epilepsy with neuropsychological regression and continuous spike waves during sleep: epilepsy surgery in a young adult.We describe the case of a man with a history of complex partial seizures and severe language, cognitive and behavioural regression during early childhood (3.5 years), who underwent epilepsy surgery at the age of 25 years. His early epilepsy had clinical and electroencephalogram features of the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia (landau-kleffner syndrome), which we considered initially to be of idiopathic origin. seizures recurred at 19 years and presurgical investigations at 25 years showed a lateral frontal epileptic focus with spread to Broca's area and the frontal orbital regions. Histopathology revealed a focal cortical dysplasia, not visible on magnetic resonance imaging. The prolonged but reversible early regression and the residual neuropsychological disorders during adulthood were probably the result of an active left frontal epilepsy, which interfered with language and behaviour during development. Our findings raise the question of the role of focal cortical dysplasia as an aetiology in the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/10. Primary neonatal thalamic haemorrhage and epilepsy with continuous spike-wave during sleep: a longitudinal follow-up of a possible significant relation.epilepsy with continuous spike-waves during sleep was diagnosed in a child who suffered primary neonatal thalamic haemorrhage, and who was followed from birth to 17 years of age. Early cognitive development was normal. Acquired behavioural problems and cognitive stagnation could be directly related to the epilepsy and not to the initial lesion and posthaemorrhagic hydrocephalus. This case and long-term follow-up data on a few children who suffered primary neonatal thalamic haemorrhage suggest that epilepsy with continuous spike-waves during sleep can be a sequel. Disturbances of thalamocortical interactions could play a role in the still poorly understood syndrome of epilepsy with continuous spike-waves during sleep.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
3/10. Neuropsychiatric manifestations of defect in mitochondrial beta oxidation response to riboflavin.A 29 year old woman is described with severe hyperemesis gravidarum, atypical migraine, numerous admissions to hospital for psychiatric illness, non-epileptic seizures, and valproate-induced coma. Metabolic studies and measurement of [9,10(n)-3H]palmitate oxidation by cultured fibroblasts suggested a multiple acyl-CoA dehydrogenation disorder. Treatment with riboflavin abolished headaches and abnormal behaviour and normalised the plasma free carnitine level. Subtle defects in mitochondrial beta oxidation may be a treatable cause of disordered behaviour in adults.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/10. A case of systemic lupus erythematosus with complex partial status epilepticus.We describe a woman with systemic lupus erythematosus who had complex partial status epilepticus as the sole epileptic manifestation. The patient presented with a confusional state, initially considered to be psychotic in nature, due to SLE. However, the EEG demonstrated the epileptic etiology of her symptoms. In patients with lupus presenting with prolonged episodes of confusion and behavioural disturbance, an EEG should be performed, whenever possible during the episode, even in the absence of a previous history of epilepsy.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
5/10. Fast improvement of verbal memory function after left temporal tumour resection.CASE REPORT: A 7-y-old, right-handed girl presented at our clinic with complex partial seizures, behavioural problems and word-finding difficulties. Clinical examination was normal, but electroencephalogram revealed bilateral epileptic discharges in the temporal and paracentral leads. magnetic resonance imaging showed an intracerebral mass in the left mesial temporal lobe in the areas of the gyrus temporooccipitalis medialis and gyrus parahippocampalis. Neuropsychological testing brought to light an above-average general intelligence, but the girl performed below average in verbal memory tests and average in figural memory tests. RESULTS: The tumour was completely removed by surgery. Neuropsychological testing 3 and 11 wk after tumour resection demonstrated above-average verbal learning and memory abilities and improved visual memory. The emotional disturbances, seizures and electroencephalogram abnormalities disappeared completely during the postoperative follow-up. CONCLUSION: After resection of a left temporal brain tumour, the patient was free of seizures, and neuropsychological functions recovered completely within weeks.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
6/10. Postictal behaviour in temporal lobe epilepsy.Postictal phenomena such as nose-wiping, coughing and hypersalivation are believed to reflect a purposeful reaction to hypersecretion after regaining consciousness following a complex partial seizure, and are very common in patients with temporal lobe epilepsy, particularly in mesial temporal lobe epilepsy. nose-wiping is usually performed with the hand ipsilateral to the side of seizure onset. Our patient illustrates an unusual, exaggerated postictal behaviour consisting of long-lasting nose-wiping, coughing and guttural sounds following a complex partial seizure due to right mesial temporal lobe epilepsy. [Published with video sequences].- - - - - - - - - - ranking = 2.5keywords = behaviour (Clic here for more details about this article) |
7/10. limbic encephalitis: a case report.We report a case of a 24 year old patient, who presented with simple and complex partial epileptic seizures, progressive changes in behaviour and affect including marked aggression, and a decline in memory to the point of inability to learn. Extensive work-up resulted in a final diagnosis of limbic encephalitis. This diagnosis was supported by a number of investigations performed during the follow-up of 6 years and ranging from the basic EEG to the more sophisticated investigations of magnetic resonance tomography, magnetoencephalography and positron emission tomography.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
8/10. Epileptic akinetic mutism: following temporal lobectomy for Rasmussen's syndrome.A girl aged 9 years with Rasmussen's encephalitis previously treated by left temporal lobectomy suddenly developed prolonged attacks of extremely rapid respirations associated with poverty of body movements and greatly reduced facial movements with loss of speech. Her comprehension appeared intact and she responded to certain requests. Her eye gaze behaviour suggested a high degree of vigilance. The attacks would last from minutes to hours and were repeated up to a dozen times daily. In the context of the stress generated by the illness and other family problems the attacks had been mistaken for an hysterical elaboration. Their ictal nature was confirmed by EEG/video monitoring. Possible links with other developmental language disorders associated with epilepsy are discussed, including a model of autism.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
9/10. Trimethylaminuria associated with seizures and behavioural disturbance: a case report.A 16-year-old left-handed male is presented with a history of seizures associated with a fish-like odour and behavioural disturbances thought to be related to trimethylaminuria. His seizures were complex-partial (cursive) seizures and started at the age of 18 months. They occurred in the context of discrete episodes several times per year. The episodes would start with a fish-like odour, followed by seizures occurring in clusters and behavioural disturbance consisting of agitation, mixed affective symptoms, auditory hallucinations and delusions. A urinary assay of trimethylamine (TMA) was elevated, confirming the diagnosis of trimethylaminuria in this patient. He was treated with a choline-restricted diet with resolution of his symptoms. The occurrence of seizures and psychiatric disturbance in this patient was thought secondary to his trimethylaminuria due to the temporal relationship of his seizures and psychiatric disturbance with the odour and his response to treatment. The possible relationship of trimethylaminuria to seizures and to psychiatric disturbance are discussed and a review of the literature presented.- - - - - - - - - - ranking = 3keywords = behaviour (Clic here for more details about this article) |
10/10. tourette syndrome, epilepsy, and emotional disorder, a case of triple comorbidity.We present a case report illustrating the complexity encountered in the diagnosis and treatment of patients with multiple diagnoses. The clinical presentation in tourette syndrome, and the behavioural manifestations in some cases of complex partial seizures can both be misunderstood and misdiagnosed. The paper, within the framework of a case, emphasises the need for a multidisciplinary approach in the assessment and management of such cases.- - - - - - - - - - ranking = 0.5keywords = behaviour (Clic here for more details about this article) |
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