Case Studies in Epilepsy

Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning – all desirable generic skills for health care professionals. Epilepsy is amongst the most frequently encountered of neurological disorders. There are important emerging clinical management issues (e.g., first seizure, therapy-resistant seizures, ICU, pregnancy) but also differential diagnosis of non-epileptic seizures (syncopy, pseudo-seizure, paroxysmal dystonic syndromes, sleep disorders, psychosis, inborn errors of metabolism, etc.). This selection of epilepsy case studies will inform and challenge clinicians at all stages in their careers. Including both common and uncommon cases, Case Studies in Epilepsy reinforces the diagnostic skills and treatment decision-making processes necessary to treat epilepsy and other seizures confidently. Written by leading experts, the cases and discussions work through differential diagnoses, treatments and social consequences in pediatric and adult patients. Features • Includes recommended treatment plans which aid quick and accurate treatment of patients • Case studies enable learning from real experiences • Collects experiences from different European countries   Table of Contents Preface Part I. Diagnosis: 1. First seizure: is it epilepsy? 2. Intractable epilepsy and epilepsia partialis continua associated with respiratory chain deficiency 3. Reasons for violent behaviour – when a man strangles his wife 4. Repetitive monocular eye adduction 5. Febrile infectious-related epilepsy syndrome (FIRES) 6. Epileptic seizures as presenting symptom of the Shaken Baby Syndrome 7. Benign rolandic epilepsy 8. New onset focal and generalized epilepsy in an elderly patient 9. When laughing makes the child fall down 10. Epileptic spasms and abnormal neuronal migration 11. A feeling of gooseflesh 12. Generalized epilepsy in adolescence as initial manifestation of Lafora disease 13. Epilepsy with a right temporal hyperintense lesion in MRI 14. Epileptic falling seizures associated with seizure-induced cardiac asystole in drug-resistant temporal lobe epilepsy 15. Seizures, dementia and stroke? 16. Comorbidity in epilepsy – dual pathology resulting in simple focal, complex focal and tonic clonic seizures 17. Minor motor events 18. Epilepsy in the ring chromosome 20 19. A late diagnosis of medial temporal lobe epilepsy 20. Experimental phenomena in temporal lobe epilepsy 21. The use of depth EEG (SEEG) recordings in a case of frontal lobe epilepsy 22. A frontal lobe epilepsy surgery based on totally non-invasive investigations 23. A young man with reading-induced seizure 24. The lady from 'no-man's-land' 25. The man who came (too) late 26. Paraneoplastic limbic encephalitis 27. Really a cerebrovascular story? 28. Sudden unexpected death in epilepsy – the ultimate failure 29. Blind but able to see 30. Seizure disorder! Really unexpected? 31. Transient epileptic amnesia in late onset epilepsy 32. A really unexpected injury? 33. Epileptic negative myoclonus in benign rolandic epilepsy 34. Sporadic hemiplegic migraine 35. A strange symptom: psychotic or ictal? 36. Hearing voices: focal epilepsy guides diagnosis of genetic disease 37. Life threatening status epilepticus due to focal cortical dysplasia 38. Childhood occipital idiopathic epilepsy Part II. Treatment: 39. Unconscious: never again work above a meter? 40. A patient's patience 41. Idiopathic absence epilepsy: unusual AED consumption successful 42. Woman with gastric reflux – careful with combinations of medications 43. An example of both pharmacodynamic and pharmacokinetic interactions 44. Never give up trying to find the right medication even in patients who are refractory 45. Juvenile myoclonic epilepsy and seizure aggravation 46. Episodic aphasia – surgery or not? 47. Temporal lobe epilepsy: drugs or surgery? 48. Shaking in elderly: reversible or fate? 49. Failure of surgical treatment in a typical medial temporal lobe epilepsy 50. Cutaneous adverse reactions by AEDs: chance or predetermination? 51. Timing of medical and surgical treatment of epilepsy: a hemispherotomy that would have prevented disabling cerebellar atrophy 52. Anticonvulsive drugs for gate disturbance and slurred speech? 53. Unsuccessful surgery: another chance? 54. If it's not broken, don't fix it! 55. Never ever give up 56. Hippocampal deep brain stimulation may be an alternative for resective surgery in medically refractory temporal lobe epilepsy 57. Myoclonic seizures and recurrent nonconvulsive status epilepticus in Dravet syndrome 58. Functional hemispherotomy for drug-resistant post-traumatic epilepsy 59. Pharmo-resistent epilepsy? 60. Vagus nerve stimulation for epilepsy 61. The strange behaviour of a vegetarian: a diagnostic indicator for treatment? Index.