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12-2017 | Challenge epilepsy surgery

A 26-year-old male patient has suffered from epilepsy for the lasts 7 years. Seizures are characterized by impaired awareness and few oral automatisms, duration is 40 sec. On specific questioning, the patient reports some kind of warning sign which he cannot describe very well, but which most likely corresponds to pressuring sensations in the gastric […]

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11-2017 | Caution with valproate in the elderly

A 83-year-old female patient had her first two focal seizures with impaired awareness (previously termed: complex-partial seizure) some weeks ago. CCT demonstrated moderate vascular leukencephalopathy, but the patient did not suffer from clinically relevant cognitive deficits. Two unprovoked epileptic seizures are associated with an increased risk for further seizures, this defines epilepsy and generally presents […]

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10-2017 | Antiepileptic drug after first seizure?

A 73-year-old male otherwise healthy patient suffered in April 2017 from a first unprovoked tonic clonic generalized seizure. Brain MRI as well as routine and sleep EEG were normal. Thus, this seizure is classified as isolated unprovoked epileptic seizure without significantly increased risk for seizure recurrence. In this constellation, the regular intake of an antiepileptic […]

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9-2017 | Improved quality of life with fewer antieptileptic drugs

A 33-year-old female patient with intellectual disability suffers from epilepsy with complex-partial and former secondary generalized seizures since early childhood. Etiology is unclear, brain MRI demonstrates at most some moderate global cortical atrophy. The patient has a history of taking 10 different antiepileptic drugs, currently she is administered 3,000 mg levetiracetam, 1,800 mg carbamazepine, and […]

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8-2017 | Five grand mal so far but no antiepileptic drugs

A just 18-year-old male patient has epilepsy with likely tonic clonic generalized seizure out of sleep for the last 2 years. The patient does not remember seizure onset, third party observations are not available. At some mornings, the patient remarked strong muscle ache and lateral tongue bites. This constellation does not allow to make another […]

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7-2017 | Adolescent with former absence seizures

Since his 6th year of life, a 14-year-old male adolescent patient suffers from multiple short (5 to 7 sec) periods with loss of contact. Former EEGs demonstrated generalized 3/sec spike-wave-complexes with maximal amplitude in frontal leads. Back then, the diagnosis of childhood absence epilepsy was made. When absence seizures manifest dozens of times per day, […]

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6-2017 | Lasertherapy in epilepsy

A 38-year-old male patient has suffered from epilepsy for more than 20 years, complex partial seizures lasting 30-40 sec. manifest 4-5 times per month; in the past, he also had generalized tonic clonic seizures. Epilepsy likely is caused by cMRI-proven hippocampal sclerosis on the right. So far, the patient had been treated with six different […]

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5-2017 | Cannabis in epilepsy

A 27-year-old female patient suffers for 12 years from epilepsy with yearly one to two „smaller“ seizures with impaired consciousnes for 30-40 sec. (complex partial seizures) and former „bigger“ seizures with loss of consciousness (generalized tonic clonic seizures). The cause of epilepsy is unknown, thus we made the diagnosis of cryptogenic focal epilepsy. The patient […]

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4-2017 | Improved seizure control with perampanel

A 35-year-old male patient suffers from difficult-to-treat focal epilepsy since his 17th year of life. Presumably, the cause of epilepsy is a former inflammatory brain disorder. First seizures occurred in the acute phase of his CNS inflammation. Currently, the patient suffers from 3-4 complex partial seizures per month, each preceded by an undetermined aura, and […]

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3-2017 | Frontal lobe resection in adolescent with epilepsy

A 16-year-old boy suffers from focal epilepsy since his 3rd year of life. Epilepsy is manifesting with sleep-bound hypermotor seizures. He awakes from sleep – somtimes multiple times per night – with marked bilateral, but asymmetric movements of all extremities, consciousness is preserved, duration generally is shorter than 1 min. Every week, seizures occur in […]

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2-2017 | Withdrawal of antiepileptic drugs

A 69-year-old male patient had a first sleep-bound generalized tonic-clonic seizure 2 years ago. Brain MRI revealed moderate vascular leukencephalopathy, some lacunar lesions were located closely to cortical structures. Routine EEG was normal. In this constellation, it is likely that the microangiopathic cerebral lesions are the cause for this patient’s first seizure. The risk for […]

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1-2017 | Recommendation of epilepsy surgery

A 25-year-old male patient suffers for 8 years from focal epilepsy characterized by epigastric auras (sensation ascending from the stomach to the throat) and automotor seizures (impaired consciousness with oral automatisms). Frequency of the latter seizure type is 4-5 per month. 1.5 T cranial MRI is normal. Current antiepileptic drug treatment consists of 3,000 mg […]

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