2019, Number 3
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Rev Cubana Pediatr 2019; 91 (3)
Atypical evolution of Panayiotopoulos syndrome to continuous spikes and wave’s syndrome during slow sleep
Garófalo GN, Vargas DJ, Novoa LLM, de Greta BLV
Language: Spanish
References: 14
Page: 1-7
PDF size: 479.14 Kb.
ABSTRACT
Introduction: Idiopathic focal epilepsies are one of the most frequent epilepsy groups in
childhood. Exceptionally, patients with this type of epilepsy have atypical evolutions that
constitute a diagnostic and therapeutic challenge.
Objective: To illustrate the atypical evolution of idiopathic focal epilepsy, type
Panayiotopoulos.
Case presentation: A 13-year-old adolescent who presented his first epileptic seizure at
5 years old, of short duration, while he slept had an eye opening, deviation of the eyes to the
left, abundant salivation and vomiting. In three years he had only three seizures. He did not
receive treatment with antiepileptic drugs until after the third seizure, which was longer.
After starting treatment with carbamazepine, he began to have learning difficulties and
marked hyperactivity. A sleep’s interictal electroencephalogram showed continuous spikes
and wave’s discharges during the slow sleep. After two years of treatment, the normalization
of the sleep electroencephalogram was achieved, with withdrawal of carbamazepine, and
progressive introduction of clobazam and magnesium valproate. The patient remained
evolutionarily with learning difficulties, with significant improvement in hyperactivity,
without recurrence of seizures.
Conclusions: The case presented is an infrequent example of a patient with idiopathic focal
epilepsy with atypical evolution, probably induced by carbamazepine, with clinicalelectroencephalographic symptoms during more than two years, with improvement favored
by the final treatment used, the natural evolution of the syndrome or the effect of both.
REFERENCES
Pal DK, Ferrie C, Addis L, Akiyama T, Capovilla G, Caraballo R, et al. Idiopathic focal epilepsies: the “lost tribe” [videotape]. Epileptic Disord Int Epilepsy J. 2016;18(3):252-88.
Camfield P, Camfield C. Regression in children with epilepsy. Neurosc Biobehav Rev. 2019;96:210-8.
Caraballo RH, Cersósimo RO, Fejerman N. Childhood occipital epilepsy of Gastaut: a study of 33 patients. Epilepsia. 2008;49(2):288-97.
Caraballo R, Cersósimo R, Fejerman N. Panayiotopoulos syndrome: a prospective study of 192 patients. Epilepsia. 2007;48(6):1054-61.
Caraballo RH, Aldao M del R, Cachia P. Benign childhood seizure susceptibility syndrome: three case reports [videotape]. Epileptic Disord Int Epilepsy J. 2011;13(2):133-9.
Lemke JR, Lal D, Reinthaler EM, Steiner I, Nothnagel M, Alber M, et al. Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes. Nat Genet. 2013;45(9):1067-72.
Yoshinaga H, Kobayashi K, Shibata T, Inoue T, Oka M, Akiyama T. Manifestation of both emetic seizures and sylvian seizures in the same patients with benign partial epilepsy. Brain Dev. 2015;37(1):13-7.
Striano P, Capovilla G. Epileptic encephalopathy with continuous spikes and waves during sleep. Curr Neurol Neurosc Rep. 2013;13(7):360.
Kramer U, Zelnik N, Lerman-Sagie T, Shahar E. Benign childhood epilepsy with centrotemporal spikes: clinical characteristics and identification of patients at risk for multiple seizures. J Child Neurol. 2002;17(1):17-9.
Fejerman N, Caraballo R, Tenembaum SN. Atypical evolutions of benign localizationrelated epilepsies in children: are they predictable? Epilepsia. 2000;41(4):380-90.
Veggiotti P, Pera MC, Teutonico F, Brazzo D, Balottin U, Tassinari CA. Therapy of encephalopathy with status epilepticus during sleep (ESES/CSWS syndrome): an update [videotape]. Epileptic Disord Int Epilepsy J. 2012;14(1):1-11.
Caraballo RH, Cersósimo R, De los Santos C. Levetiracetam-induced seizure aggravation associated with continuous spikes and waves during slow sleep in children with refractory epilepsies [videotape]. Epileptic Disord Int Epilepsy J. 2010;12(2):146-50.
Catania S, Cross H, de Sousa C, Boyd S. Paradoxic reaction to lamotrigine in a child with benign focal epilepsy of childhood with centrotemporal spikes. Epilepsia. 1999;40(11):1657-60.
Montenegro MA, Guerreiro MM. Electrical status epilepticus of sleep in association with topiramate. Epilepsia. 2002;43(11):1436-40.