Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Dec 2010
Case ReportsDoes lacosamide aggravate Lennox-Gastaut syndrome? Report on three consecutive cases.
Lennox-Gastaut syndrome is an intractable epileptic encephalopathy, with most patients experiencing daily seizures despite therapy with multiple antiepileptic drugs. New treatments need to be tested to define their efficacy in this syndrome. Lacosamide is a new antiepileptic drug recently approved for the treatment of partial-onset seizures. We describe three patients with Lennox-Gastaut syndrome resistant to conventional antiepileptic drugs whose seizures were aggravated by lacosamide.
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Epilepsy & behavior : E&B · Dec 2010
Case ReportsPosttraumatic stress disorder caused by the misattribution of seizure-related experiential responses.
Patients with temporal lobe seizures sometimes experience what John Hughlings Jackson described as "dreamy states" during seizure onset. These phenomena may be characterized by a re-experiencing of past events, feelings of familiarity (déjà vu), and hallucinations. In previous reports, patients have been aware of the illusory nature of their experiences. ⋯ He believed them to be veridical memories from his childhood, although evidence from his family suggests that they were not. The patient's psychological reaction to the "recovery" of these traumatic "memories" was severe enough to qualify as posttraumatic stress disorder (PTSD). To our knowledge, this is the first report of PTSD caused by the misattribution of mental states that accompany a seizure.
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Epilepsy & behavior : E&B · Nov 2010
Case ReportsDocumentation of autonomic seizures and autonomic status epilepticus with ictal EEG in Panayiotopoulos syndrome.
Panayiotopoulos syndrome (PS) is a common childhood susceptibility to autonomic seizures and status epilepticus. Despite its high prevalence, PS has been a source of significant debate. We present ictal EEG documentation of autonomic seizures and autonomic status epilepticus in six cases of PS and a review of 14 reported cases. ⋯ Ictal EEG onsets were also variable, starting from wide anterior or posterior regions usually with theta waves intermixed with small spikes and fast rhythms. Ictal vomiting and other autonomic manifestations, as well as deviation of the eyes, did not appear to relate to any specific region of EEG activation. These data document that PS is a multifocal autonomic epilepsy and support the view that the clinical manifestations are likely to be generated by variable and widely spread epileptogenic foci acting on a temporarily hyperexcitable central autonomic network.
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Epilepsy & behavior : E&B · Nov 2010
Letter Case ReportsPregabalin-induced severe delayed ejaculation.
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Several observations make it worthwhile to take a closer look at postictal events, which are defined as manifestations of seizure-induced reversible alterations in neuronal function. The postictal period may adversely affect the quality of life, considering the duration and severity of postictal events. ⋯ On a more positive side, the increased seizure threshold seen during the postictal period may offer clues for development of more effective seizure treatment. In this issue, experts in the field elucidate the postictal period from different viewpoints, including the mechanism of the postictal period, its diagnostic challenges, and its management.