Abstract
AHEALTHY 28 YEARold
man developed
acute pharyngitis and
fever. Three days
later he experienced
a prolonged generalized tonicclonic
seizure that required admission
into the intensive care unit. Neurological
examination findings were
unremarkable. Analysis of his cerebrospinal
fluid identified herpes simplex
DNA. Other laboratory findings
from cerebrospinal fluid analysis
were a glucose level of 69 mg/dL; a
protein level of 44 mg/dL; and leukocytes,
18/mm3. Results from electrocardiographic
monitoring showed
episodes of progressive slowing of the
heart rate that lead to severe bradycardia
(30 beats/min) and sometimes
brief periods of asystole. These
episodes lasted 1 to 2 minutes. Interictal
electrocardiographic findings
were normal, in particular long
QT syndrome was ruled out. Electroencephalographic
monitoring revealed
nonconvulsive epileptic seizures,
withoutmotormanifestations.
Epileptic discharges arose from the
right temporal lobe and spread contralaterally
(Figure 1). These seizures
recurred up to 20 times per day
and were controlled with high doses
of valproate sodium and carbamazepine.
Magnetic resonance imaging
showed a small area of abnormal signal
below the right insular cortex
(Figure 2). In 6 weeks the patient
fully recovered without any neurological
impairment. Antiepileptic
treatment was continued, and he experienced
no seizures in the following
6 months.
Lingua originale | English |
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pagine (da-a) | 830-831 |
Numero di pagine | 2 |
Rivista | Archives of Neurology |
Volume | 65 |
DOI | |
Stato di pubblicazione | Pubblicato - 2008 |
Keywords
- Adult
- Electroencephalography
- Epilepsy
- Heart Arrest
- Humans
- Magnetic Resonance Imaging
- Male