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By Dieter Schmidt, Steven C. Schachter

From pediatric to the aged, from contractible to refractive, epilepsy is an disease that manifests in lots of kinds and throughout various demographics. during this interesting quantity, the writer info multiple hundred circumstances the place healthiness care practitioners confronted strange demanding situations in treating the sickness. All facets of epilepsy are explored via those circumstances, from the occasionally complicated preliminary analysis to sufferer responses and remedy equipment. during this best-selling brief textual content, the writer additionally provides the teachings realized from those remarkable instances. one hundred ten perplexing situations in Epilepsy comes in handy for scientific scholars, citizens and all healthiness care practitioners, because the practices used to appreciate those circumstances will be utilized to different diagnoses besides.

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Ictal recordings, which were initially obscured by muscle artifacts, were characterized by theta-wave activity over the right temporal lobe. Magnetic resonance imaging (MRI) scans were negative but positron emission tomography demonstrated right temporal hypometabolism consistent with the localization of hyperperfusion during an ictal single photon emission computed tomography examination. 1: Intracranial recording of the initial part of a complex partial seizure. Channel 8 shows low-amplitude fast activity in the anterior cingulate gyrus before and during a fast spread of seizure activity to the left hippocampus (channel 7) and right hippocampus (channel 5).

31 PANIC ATTACKS IN A WOMAN WITH FRONTAL LOBE EPILEPSY Because the patient has now been seizure-free for 24 months, we have started to taper her carbamazepine and lamotrigine. Commentary This case demonstrates the importance of seizure semiology. During the presurgical evaluation of our patient, the results from non-invasive electrophysiological and functional imaging studies all pointed to the seizures originating within the right temporal lobe. In addition, our patient experienced auras with fear and déjà-vu and exhibited non-verbal memory deficits.

She typically had one or two complex partial or secondary generalized seizures every morning with as many as 50–60 seizures in one day. She became aware of her seizures at the age of 5, describing ‘weird feelings in her head’ followed by a scared look, and then her head and eyes would roll back with stiffening and shaking. Several routine EEGs were normal. Her seizures failed to respond to all available antiepileptic drugs. During video-EEG monitoring at the age of 16, she had diffuse anterior hemispheric seizure onset, maximal on the left, as well as numerous psychic sensations that were unaccompanied by EEG changes.

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