By Dieter Schmidt, Steven C. Schachter
From pediatric to the aged, from contractible to refractive, epilepsy is an affliction that manifests in lots of types and throughout a number demographics. during this attention-grabbing quantity, the writer information a couple of hundred cases the place wellbeing and fitness care practitioners confronted strange demanding situations in treating the disorder. All points of epilepsy are explored via those circumstances, from the occasionally complicated preliminary analysis to sufferer responses and therapy tools. during this best-selling brief textual content, the writer additionally offers the teachings realized from those outstanding circumstances. a hundred and ten confusing situations in Epilepsy comes in handy for clinical scholars, citizens and all well-being care practitioners, because the practices used to appreciate those circumstances may be utilized to different diagnoses in addition.
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Fundoscopy was normal – there was no optic atrophy or abnormal retinal pigmentation. Neurological examination showed no abnormalities of speech, hearing or vision. His gait was mildly ataxic and his ﬁne motor skills were delayed to that of a child aged between 18 and 20 months. Cranial nerve examination was normal. There was no nystagmus, but his eye movements were jerky. Muscle tone was increased in his lower limbs and muscle stretch reﬂexes were brisk with extensor plantar responses. Frequent, brief myoclonic seizures affecting his head and body were observed.
Commentary Both patients illustrate that symptomatic and cryptogenic infantile spasms can persist into adulthood, apparently indeﬁnitely. Experts in several recently published textbooks suggest that West syndrome is a disorder of infants only, which is true if persistent hypsarrhythmia is required for the diagnosis. 2 What did we learn from these cases? First, infantile spasms may reappear in adult life. Adults with spasms must be rare and we do not think that spasms begin de novo in adulthood – they always start before the age of 4 years.
Yalcin AD, Forta H. Primary reading epilepsy. Seizure 1998;7:325–7. 6. Wolf P, Mayer T, Reker M. Reading epilepsy: report of ﬁve new cases and further considerations on the pathophysiology. Seizure 1998;7:271–9. 7. Saenz-Lope E, Herranz-Tannaro FJ, Masdeu JC. Primary reading epilepsy. Epilepsia 1985;26:649–56. 8. Daly RF, Forster FM. Inheritance of reading epilepsy. Neurology 1975;25:1051–4. 5 Case 2 JERKY EYE MOVEMENTS IN A 2-YEAROLD-BOY WITH EPILEPTIC SEIZURES Richard E Appleton History A 10-year-old boy initially presented at the age of 29 months after one generalized tonic–clonic seizure and one partial seizure.
110 puzzling cases of epilepsy by Dieter Schmidt, Steven C. Schachter