The intoxicated EEG

نویسندگان

  • A. A. Tarnutzer
  • L. L. Imbach
چکیده

A 38-year old male patient with pharmacoresistant bilateral temporal-lobe epilepsy was referred to our department for adjustment of antiepileptic-drug dosage with continuous VideoEEG monitoring. In 2013, bilateral deep brain electrodes were implanted for chronic stimulation in both anterior thalamic nuclei. After implantation, the patient remained seizure free of generalized tonic-clonic seizures, but continued to experience daily complex-partial seizures typically presenting with initial dizziness, shortness of breath and a short period of unresponsiveness. Before admission, he was treated with levetiracetam (1 g twice a day), lamotrigine (500 mg twice a day) and oxcarbazepine (600 mg twice a day). Due to insufficient seizure control and likely levetiracetam-associated aggressive behavior the following modifications were applied: At admission (day1) levetiracetam dosagewasreducedtothehalf (and completely stopped on day 3), while valproid acid was started at a low dose (300 mg twice a day). Accidentally, on day 2 the oxcarbazepine dosage was doubled in the evening (from 600 mg to 1200 mg). The next day (day 3) the patient again received the double oxcarbazepine dose in the morning and few hours later he presented with acute vertigo, nausea and vomiting. Continuous EEG-monitoring showed steep surface-negative excursions followed by shallow return to baseline (frequency = 2–3/s) that were most prominent in frontal derivations after eyes opening (Fig. 1A, arrows). This pattern was interpreted as rhythmic eye movements with slow upward phase and fast downward phase, i.e., downbeat-nystagmus (DBN). On clinical neurological examination DBN was confirmed, while no otherfocal neurologicaldeficits were found. Emergency brain CT was reportedly normal, excluding structural causes of acute DBN. Oxcarbazepine serum levels were supra-therapeutic (147.4 mmol/

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

A Novel Approach for the Detection of Drunken Driving using the Power Spectral Density Analysis of EEG

In today’s scenario, more and more people are required to travel back and forth to various places. With the increasing vehicular population and their movements on the roads, accidents are also steadily increasing. It has become a nightmare for the authorities to prevent /reduce such fatal accidents on the roads. But the authorities’ efforts are in vain. It is shocking to know the study results ...

متن کامل

Transient global amnesia with post-hyperventilation temporal sharp waves—A case report

We report a 55-year-old woman, who presented with transient amnesia for 7h following underwater swimming. There was no evidence of neurological disturbance except global amnesia. Sharp waves in both temporal regions were registered during the initial EEG recording, which was accentuated by hyperventilation. Right hippocampal high signal intensity was observed in DWI performed 56 h after symptom...

متن کامل

Protective Effect of Salvia officinalis on Testes Tissue Damages of Rats Intoxicated by Diazinon

Diazinon is an organophosphate which exerts tissue damages by generating free radicals thereby inducing oxidative stress. The purpose of this study is to determine the protective effect of Salvia officinalis L.extract on testes of rats intoxicated by diazinon. In this experimental study, 45 mature male rats were equally divided into three groups of Control (C), Diazinon (DZN) and Diazinon-Extra...

متن کامل

Spreading brain lesions in a familial Creutzfeldt-Jakob disease with V180I mutation over 4 years

BACKGROUND We report a female patient with familial Creutzfeldt-Jakob disease with V180I mutation (fCJD with V180I), who was serially followed up with magnetic resonance imaging (MRI) and electroencephalogram (EEG) for up to four years. CASE PRESENTATION At 6 months after the onset, diffusion-weighted images (DWI) and fluid-attenuated inversion recovery (FLAIR) of brain MRI revealed an increa...

متن کامل

Hepatoprotective Effect of Ficus carica Leaf Extract on Mice Intoxicated with Carbon Tetrachloride

Protective action of Ficus carica leaf ethanolic extract (obtained by maceration) was evaluated in an animal model of hepatotoxicity induced by carbon tetrachloride (CCl4). Male albino mice were divided into six groups. group I was normal control group; group II received olive oil (CCl4 solvent), groups III-VI received CCl4. After inducing hepatic damage, group III served as control for CCl4; a...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Seizure

دوره 45  شماره 

صفحات  -

تاریخ انتشار 2017