De novo aphasic status epilepticus: Finally making the diagnosis by long-term EEG
| Autor: | Angeliki Kantzeli, Christian Brandt, Maria Tomka-Hoffmeister, Friedrich Woermann, Christian G. Bien |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Neurophysiology and neuropsychology
MRI Magnetic resonance imaging NCSE non-convulsive SE Oligodendroglioma Case Report CTP CT-perfusion Behavioral Neuroscience Benzodiazepines ASM antiseizure medication DWI diffusion-weighted imaging FLAIR Fluid-attenuated inversion recovery RC346-429 LPD lateralized periodic discharges QP351-495 Rhythmic theta-activity SE status epilepticus nervous system diseases Aphasic status epilepticus Neurology PCV Procarbazin/Lomustin/Vincristin Phenytoin Neurology. Diseases of the nervous system Neurology (clinical) FDG-PET fluorodeoxyglucose positron emission tomography EEG electroencephalography Structural focal epilepsy |
| Zdroj: | Epilepsy & Behavior Reports Epilepsy & Behavior Reports, Vol 17, Iss, Pp 100513-(2022) |
| ISSN: | 2589-9864 |
| Popis: | Highlights • We diagnosed aphasic non-convulsive status epilepticus (NCSE) by long-term EEG. • An additional tool for diagnosing NCSE was diffusion-weighted imaging. • It took seven months until the diagnosis was made. • NCSE was refractory oral polypharmacy and responded to intravenous phenytoin. Aphasic status epilepticus (SE) is a rare manifestation of non-convulsive SE (NCSE) and may occasionally be under-recognized. We report a 69-year-old male patient with a pre-existing left parietal oligodendroglioma WHO III after two resections and radio-chemotherapy. The patient was left with some word finding difficulties but had no history of overt seizures. He developed aphasic NCSE, which was only detected by long-term electroencephalography (EEG) monitoring. The 24-hour EEG revealed paroxysmal rhythmic theta-delta activity in left posterior regions that propagated to left temporo-parietal areas. Rhythmic activity appeared every 15–30 min and lasted for 10–110 s. Aphasia was continuously present with superimposed short-lasting clinical deteriorations during the day. Magnetic resonance imaging showed peri-ictal edema on diffusion-weighted images in the insula and fronto-parietal cortex, which supported the diagnosis of SE. NCSE persisted for seven months. The patient recovered upon addition of intravenous phenytoin. One should not only consider aphasic SE when language impairment is episodic, but also when there are prolonged manifestations, especially when the typical differential diagnoses have been excluded. Intravenous therapy may be required to terminate NCSE. With this report, we would like to draw attention to aphasic SE as a rare phenomenon that may be difficult to diagnose and delay management in clinical practice. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|