Puzzling Cases of Epilepsy

<br>Preface to the second edition</br><br>List of Contributors </br><br>Part I Diagnostic Puzzles and Uncertainties</br><br> 1. A Young Woman with Mouth Jerking Provoked by Reading</br><br> 2. Two Adult Patients with Infantile Spasms</br><br> 3. An Infant with Partial Seizures and Infantile Spasms</br><br> 4. Epilepsia Partialis Continua versus Non-Epileptic Seizures</br><br> 5. Panic Attacks in a Woman with Frontal Lobe Epilepsy</br><br> 6. Frequent Night Terrors</br><br> 7. Genetic (Generalized) Epilepsy with Febrile Seizures Plus</br><br> 8. A Visit to the Borderland of Neurology and Psychiatry</br><br> 9. A Case of Complex Partial Status Epilepticus</br><br> 10. Late-Onset Myoclonic Seizures in Down’s Syndrome</br><br> 11. Fainting, Fear, and Pallor in a 22-Month-Old Girl</br><br>Part II Intriguing Causes and Circumstances</br><br> 12. Hyperactive Behavior and Attentional Deficit in a 7-Year-Old Boy with Myoclonic Jerks</br><br> 13. Temporal Lobe Epilepsy, Loss of Episodic Memory, and Depression in a 32-Year-Old Woman</br><br> 14. Epileptic “ Dreamy States ” in a Young Man</br><br> 15. Nocturnal Seizures in a Man with Coronary Disease</br><br> 16. Non-convulsive Status Epilepticus and Frontal Lobe Seizures in a Patient with a Chromosome Abnormality</br><br> 17. An Unusual Cause of Nocturnal Attacks</br><br> 18. Myoclonic Jerks in a Computer Specialist</br><br> 19. Their Previous Physicians had Told Them that They Should not Become Pregnant Because They have Epilepsy</br><br> 20. Status Epilepticus after a Long Day of White-Water Rafting in the Grand Canyon</br><br> 21. A Farmer Who Watched His Own Seizures</br><br> 22. The Borderland of Neurology and Cardiology</br><br> 23. A Man with Shoulder Twitching</br><br> 24. The Girl with Visual Seizures Who wasn’t Seeing Things – Transient Blindness in a Young Girl</br><br> 25. A Young Man with Noise-Induced Partial Seizures</br><br> 26. Non-convulsive Status Epilepticus in a Patient with Idiopathic Generalized Epilepsy</br><br> 27. Pseudohypoglycemia Manifesting as Complex Partial Seizures in a Patient with Type III Glycogen Storage Disease</br><br>Part III Surprising Turns and Twists</br><br> 28. Recurrent Amnestic Episodes in a 62-Year-Old Diabetic Patient</br><br> 29. Attacks of Nausea and Palpitations in a Woman with Epilepsy</br><br> 30. Absence Status Epilepticus in a 60-Year-Old Woman</br><br> 31. Hemiplegia in a 76-Year-Old Woman with Status Epilepticus</br><br> 32. Persistence Pays Off</br><br> 33. Drugs Did Not Work in a Little Girl with Absence Seizures</br><br> 34. “ Alternative ” Therapy for Partial Epilepsy – with a Twist</br><br> 35. A 19-Year-Old Man with Epilepsy, Aphasia, and Hemangioma of the Cranial Vault</br><br> 36. Severe Psychiatric Disorder in an 8-Year-Old Boy with Myoclonic–Astatic Seizures</br><br> 37. A Girl with Two Epilepsy Syndromes</br><br> 38. The Obvious Cause of Seizures May Not Be the Underlying Cause</br><br> 39. Absence Seizures in an Adult</br><br> 40. A Case Solved by Seizures During Sleep</br><br> 41. Alternative Psychosis in an Adolescent Girl?</br><br> 42. Exacerbation of Seizures in a Young Woman</br><br> 43. Genetic Counseling in a Woman with a Family History of Refractory Myoclonic Epilepsy</br><br> 44. “ Funny Jerks ” Run in the Family</br><br> 45. Side Effects That Imitate Seizures</br><br> 46. Epilepsy, Migraine, and Cerebral Calcifi cations</br><br> 47. An Unusual Application of Epilepsy Surgery</br><br> 48. All is Not What it Seems</br><br> 49. A Patient Whose Epilepsy Diagnosis Changed Three Times Over 20 Years</br><br> 50. If You Don’t Succeed, Investigate</br><br> 51. Should He or Shouldn’t He? Is It Reasonable to Prescribe Carbamazepine after Lamotrigineinduced Stevens–Johnson Syndrome?</br><br> 52. The Value of Repeating Video–EEG Monitoring and the Importance of Concomitant ECG Tracings in the Evaluation of Changes in Seizure Semiology</br><br>PART IV Unforeseen Complications and Problems</br><br> 53. A 35-Year-Old Man with Poor Surgical Outcome after Temporal Lobe Surgery</br><br> 54. When More is Less</br><br> 55. Change of Antiepileptic Drug Treatment for Fear of Side Effects in a 45-Year-Old Seizure-Free Patient</br><br> 56. Personality and Mood Changes in a Teenager</br><br> 57. Monitoring Patients May Be More Important Than Their Laboratory Tests</br><br> 58 Depression in a Student with Juvenile Myoclonic Epilepsy</br><br> 59. Osteomalacia in a Patient Treated with Multiple Anticonvulsants</br><br> 60. Parkinsonism and Cognitive Decline in a 64-Year-Old Woman with Epilepsy</br><br> 61. Problems in Managing Epilepsy during and after Pregnancy</br><br> 62. Status Epilepticus in a Heavy Snorer</br><br> 63. A Boy with Epilepsy and Allergic Rhinitis</br><br> 64. Seizures and Behavior Disturbance in a Boy</br><br> 65. Abulia in a Seizure-Free Patient with Frontal Lobe Epilepsy</br><br> 66. The Continuing Place of Phenobarbital</br><br> 67. A Patient with Epilepsy Slips Down Some Attic Stairs</br><br> 68. Bilateral Hip Fractures in a 43-Year-Old Woman with Epilepsy</br><br> 69. Picking a Wrong Antiepileptic Drug for a 9-Year-Old Girl</br><br> 70. With Epilepsy You Never Know</br><br>Part V Unexpected Solutions</br><br> 71. When Antiepileptic Drugs Fail in an Infant with Seizures, Consider Vitamin B6</br><br> 72. A 12-Year-Old Boy with Daily Clonic Seizures</br><br> 73. A Child with Attention-Defi cit Disorder, Autistic Features and Frequent Epileptiform EEG Discharges</br><br> 74. Complete Seizure Control in a 14-Year-Old Boy after Temporal Lobectomy Failed</br><br> 75. Ictal Crying in a 32-Year-Old Woman</br><br> 76. Healing Begins with Communicating the Diagnosis</br><br> 77. An Unusual Case of Seizures and Violence</br><br> 78. Attacks of Generalized Shaking without Postictal Confusion</br><br> 79. Lennox–Gastaut Syndrome with Good Outcome Associated with Perisylvian Polymicrogyria</br><br> 80. Temporal Lobe Resection in a Patient with Severe Psychiatric Problems</br><br> 81. An Open Mind Can Benefi t the Patient</br><br> 82. An Unexpected Lesson</br><br> 83. When Surgery Is Not Possible, All Hope Is Not Lost</br><br> 84. Sometimes Less Is More</br><br> 85. Unexpected Benefit from an Old Antiepileptic Drug</br><br> 86. Status Epilepticus Responsive to Intravenous Immunoglobulin</br><br> 87. Surgical Success in a Patient with Diffuse Brain Trauma</br><br> 88. Dietary Treatment of Seizures from a Hypothalamic Hamartoma</br><br> 89. Can the Behavioral and Cognitive Effects of AEDs Be Predicted?</br><br> 90. A Child with So-Called Nocturnal Paroxysmal Dystonia Whose Epilepsy Arose from Orbital Cortex</br><br> 91. The Night Mom Didn’t Come Back</br><br> 92. The EEG – Not the EEG Report – Makes the Difference</br><br>Part VI Where Clinical Knowledge and Preclinical Science Meet</br><br> 93. The Double-Hit Hypothesis: Is It Clinically Relevant?</br><br> Comment: The Double-Hit Hypothesis: Is It Clinically Relevant?</br><br> 94. Atypical Evolution in a Case of Benign Childhood Epilepsy with Centrotemporal Spikes</br><br> Comment 1: Does Kindling in Humans Occur? Comments Based on the Previous Case Study</br><br> Comment 2: Does Kindling in Humans Occur?</br><br> Comments Based on the Previous Case from a Preclinical Perspective</br><br> 95. Does Status Epilepticus Represent a Different Pathophysiology than Epilepsy? A Patient with Recurrent Status Epilepticus as the Single Manifestation of Her Epilepsy</br><br> Comment 1: Does Status Epilepticus Represent a Different Pathophysiology than Epilepsy? A Preclinical Perspective</br><br> Comment 2: Does Status Epilepticus Represent a Different Pathophysiology than Epilepsy? A Clinical Perspective</br><br> 96. Why Do Some Patients Seem to Develop Tolerance to AEDs? Development of Antiepileptic Drug Tolerance in a Patient with Temporal Lobe Epilepsy</br><br> Comment 1: Why Do Some Patients Seem to Develop Tolerance to AEDs? A Preclinical Discussion</br><br> Comment 2: How Can We Detect the Development of Tolerance (Loss of Effect) to AEDs in Patients with Epilepsy? A Clinical Discussion</br><br> 97. Why Is There a Similar Ceiling Effect for the Efficacy of Most If Not All Antiepileptic Drugs in Adult Epilepsy? Reaching the Ceiling or Hitting the Wall?</br><br> Comment 1: Why Is There a Similar Ceiling Effect for the Effi cacy of Most If Not All Antiepileptic Drugs in Adult Epilepsy? A Clinical Perspective</br><br> Comment 2: What Clinical Observations on the Epidemiology of Antiepileptic Drug Intractability Tell Us About the Mechanisms of Pharmacoresistance</br><br> 98. Difficult-to-Treat Idiopathic Generalized Epilepsy in a Young Woman</br><br> Comment 1: Can We Predict a Drug’s Efficacy in a Specifi c Epilepsy Syndrome? A Preclinical Discussion</br><br> Comment 2: Bridging the Gap between Evidence-Based Medicine and Clinical Practice</br><br> 99. Psychogenic Non-Epileptic Seizures “ Redux ”</br><br> Comment 1: Is There a Neurobiological Basis to Stress-induced, Non-epileptic Behaviors that Mimic Seizures?</br><br> Comment 2: Evidence for a Neurobiological Basis for Non-epileptic Seizures</br><br> 100. Why Does VNS Take So Long to Work?</br><br> Comment 1: Commentary: Why Does VNS Take So Long to Work? </br><br> 101. If at First You Don’t Succeed</br><br> Comment 1: Why Antiepileptic Drugs Fail in Some Patients: A Preclinical Perspective</br><br> Comment 2: The Continuing Conundrum of Reversible Drug-resistant Epilepsy: A Clinical Perspective</br><br> 102. Why Do Some Patients Have Seizures After Brain Surgery While Others Do Not?</br><br> Comment 1: Why Do Some Patients Have Seizures After Brain Surgery While Others Do Not? A Comment on the Evidence</br><br> Comment 2: Why Do Some Patients Have Seizures After Brain Surgery While Others Do Not? A Clinical Perspective</br><br>Index</br>