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 info a couple of hundred circumstances the place healthiness care practitioners confronted strange demanding situations in treating the sickness. All points of epilepsy are explored via those circumstances, from the occasionally complicated preliminary prognosis to sufferer responses and remedy tools. during this best-selling brief textual content, the writer additionally provides the teachings discovered from those impressive instances. a hundred and ten complicated instances in Epilepsy turns out to be useful for scientific scholars, citizens and all well-being care practitioners, because the practices used to appreciate those situations could be utilized to different diagnoses besides.
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Extra resources for 110 Puzzling Cases of Epilepsy
This probably occurred because of the patient’s inability to co-ordinate simultaneous movements on a functional basis. A similar ﬁnding has emerged in studies of posthypnotic suggestion. 10 Thus, although posthypnotic suggestion and conversion symptoms are executed without conscious awareness, they tap the same attentional networks that are used to execute conscious tasks. Although inhibition or activation of movements related to EPC may occur with voluntary motor tasks or sensory stimulation of the affected limb,11,12 this patient and two others I have seen demonstrated abolition of activity when they performed tasks using other parts of the body.
The episodes lasted from 10 minutes to 4 hours and occurred an average of four times a week. Lorazepam 2 mg/kg intravenously had been administered at another hospital during a prolonged episode but had no effect. All episodes occurred while the patient was awake and there were no precipitants such as sleep deprivation. Previous diagnostic testing included normal magnetic resonance imaging, EEG, complete blood count and blood chemistry as well as a negative Lyme titre. Examination and investigations Video-EEG monitoring revealed stereotyped sensorimotor episodes beginning with a sensation of numbness in the left hand and in the neck and face.
On the second day of life she had right-sided clonic seizures that were treated with phenobarbital. Her neurologic and skin examinations were normal. The EEG showed a left central focal spike discharge. Seizures persisted and were resistant to phenobarbital, carbamazepine and phenytoin. At 6 months of age, she had a 1-week history of somnolence and loss of eye contact associated with the onset of typical infantile spasms. Spasms consisted of raising both arms and upward eye deviation for 1–2 seconds, with spasms repeating every 10–20 seconds for 5–10 minutes.