| Popis: |
Publisher Summary This chapter highlights the case of a girl who was diagnosed with absence epilepsy. Her attacks occurred one to four times a day and consisted of a blank stare, eyelid fluttering, some jerking of the eyebrows, and rolling the eyes upward. They lasted 5–20 seconds. During this time she was motionless and unresponsive. The spells could not be interrupted. Her only medication was sulfasoxazole for prophylaxis of recurrent otitis media. Her family medical history was negative for epilepsy, seizures or other neurological disorders of significance. Her EEG revealed multiple instances of 3-Hz spike-and-slow wave generalized epileptiform discharges, sometimes with a bifrontal predominance, which were slightly exacerbated by drowsiness. A trial of amantadine improved her symptoms for 1 week, followed by yet another relapse. All medications were discontinued, and she improved, although she continued to have 20 seizures a day. She was placed on the ketogenic diet at a 4:1 ratio of fat to carbohydrate and protein calories. Her seizures immediately decreased to only a few per day. After being seizure-free for 20 months, the ratio of her ketogenic diet was gradually decreased and a weaning process was started. After being seizure-free for 2 years, the diet was discontinued. A follow-up EEG was normal. She has remained seizure free since that time. Absence epilepsy of childhood is typically a benign condition that responds well to medication in more than 90% of cases. When a truly refractory case of absence epilepsy is encountered, effective treatment options are limited. |
