110 Puzzling Cases of Epilepsy by Dieter Schmidt, Steven C. Schachter

By Dieter Schmidt, Steven C. Schachter

From pediatric to the aged, from contractible to refractive, epilepsy is an disorder that manifests in lots of kinds and throughout a number of demographics. during this attention-grabbing quantity, the writer information multiple hundred situations the place future health care practitioners confronted strange demanding situations in treating the ailment. All facets of epilepsy are explored via those instances, from the occasionally complicated preliminary prognosis to sufferer responses and therapy tools. during this best-selling brief textual content, the writer additionally offers the teachings realized from those outstanding situations. a hundred and ten difficult circumstances in Epilepsy turns out to be useful for clinical scholars, citizens and all health and wellbeing care practitioners, because the practices used to appreciate those situations will be utilized to different diagnoses to boot.

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Seizure 1997;6:67–70. 12 REFERENCES 3. Bauer J, Wagner G, Elger CE. Sturzanfälle und Status nonkonvulsiver Anfälle als besondere Behandlungsindikation von Lamotrigin: Ergebnisse einer add-on Studie bei 46 Patienten mit pharmakoresistenten epileptischen Anfällen. Aktuel Neurol 1995;22:51–4. 4. Bauer J. Seizure-inducing effects of antiepileptic drugs: a review. Acta Neurol Scand 1996;94:367–77. 5. Ettinger AB, Bernal OG, Andriola MR, et al. Two cases of nonconvulsive status epilepticus in association with tiagabine therapy.

When the patient was aged 12 months they suddenly ‘popped up’! The lesson is to keep looking if you suspect tuberous sclerosis. How did these cases alter our approach to the care and treatment of our epilepsy patients? In the follow-up of infantile spasms, we continue to ask about their reemergence. The spasms are relatively easily misdiagnosed in older people. The recognition of their intractability is depressing but an important reality. Since our experience with these two cases, we are now aware of four other patients in our center and several more in other centers.

I investigated a 30-year-old woman suffering from daily episodes of delayed responsiveness that had been classified as non-convulsive status epilepticus. The episodes of altered behaviour occurred after waking and lasted until breakfast. On investigation, it was determined that her serum glucose concentrations decreased to less than 28 mg/100ml during the night. Not surprisingly, carbamazepine had no influence on the frequency of her ‘seizures’. References 1. Shorvon S. Status Epilepticus. Cambridge: Cambridge University Press; 1994.

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