Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Feb 2010
Case ReportsSporadic hemiplegic migraine and epilepsy associated with CACNA1A gene mutation.
Familial hemiplegic migraine (FHM) is a clinically and genetically heterogeneous disease most commonly linked to CACNA1A gene mutation. Epilepsy rarely occurs in FHM and is seen predominantly with specific CACNA1A gene mutations. Here we report a sporadic case of FHM1 linked to S218L CACNA1A gene mutation with the triad of prolonged hemiplegic migraine, cerebellar symptoms, and epileptic seizures. ⋯ Clinical and electrographic status epilepticus can occur during prolonged migraine attacks. We suggest that patients with seizures, ataxia, and hemiplegic migraine be genetically tested for FHM. Patients with prolonged hemiplegic migraine attacks and confusion should be tested with continuous EEG recording to ascertain whether electrographic status is occurring, as intensive antiepileptic treatment not only resolves status but immediately stops hemiplegic migraine and improves associated neurological deficits.
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Epilepsy & behavior : E&B · Feb 2010
Levetiracetam as add-on therapy in different subgroups of "benign" idiopathic focal epilepsies in childhood.
Several recent studies have shown that levetiracetam (LEV) can be beneficial in the treatment of children with typical rolandic epilepsy (RE). Reports about the effectiveness of LEV in the treatment of children with the less benign variants in the spectrum of "benign" idiopathic focal epilepsies are still rare. Little is known about the effect of LEV on interictal epileptiform discharges in these syndromes. ⋯ The average dose of LEV was 39 mg/kg body wt per day; LEV was given in monotherapy to 31.3% of the patients. Overall, 20 of 32 patients (62.5%) did benefit: 12 of 24 patients had a >50% reduction in seizure frequency; 2 of 24 patients (8.3%) were completely seizure free; 18 of 32 patients (56.3%) had a >90% reduction in BIFEDC (including CSWS); 6 of 32 (18.8%) had an EEG completely free of epileptiform discharges; and 17 of 32 (53.1%) showed improvement in cognition and/or language functions and/or behavior. Surprisingly, LEV tended to be more helpful in atypical rolandic epilepsies and other variants.
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Epilepsy & behavior : E&B · Feb 2010
Biography Historical ArticleThe epileptic seizure and the mystery of death in Christian painting.
The epileptic seizure is in many cultures associated with death. Indo-European tradition perceives death not necessarily as the end but as a step, as a point the life cycle is passing through. ⋯ This article, originating from a case report, shows how some Christian painting alludes to renaissance after a seizure and to the parallelism between the patient with epilepsy and the destiny of Christ. Special attention is paid to Raphael's, in this respect particularly complex work, The Transfiguration.