De novo epileptic confusional status in a patient with cobalamin deficiency.
A 80-year-old man with cobalamin deficiency and no history of epilepsy developed a partial complex epileptic confusional status (ECS) unresponsive to acute i.v. diazepam. Brain CT scan and MRI investigation ruled out a focal cerebral lesion. Therapy with high doses (10,000 micrograms i.m. daily) of cobalamin alone was started, and the patient fully recovered in the following 72-hour. Control EEGs repeatedly performed days and weeks later showed progressive disappearance of the frontal interictal spiking, while the patient was on monotherapy with cobalamin (5,000 micrograms i.m. weekly). A month later the patient unfortunately discontinued replacement therapy and 13 weeks later he developed a fatal convulsive epileptic status. To our knowledge the association of ECS and cobalamin deficiency has not been previously reported.
Aguglia
U
U
Institute of Neurology, Catanzaro, Italy.
Gambardella
A
A
Oliveri
R L
RL
De Sarro
G
G
Zappia
M
M
Quattrone
A
A
D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion; D004569:Electroencephalography; D017029:Epilepsy, Complex Partial / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013226:Status Epilepticus / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000188:drug therapy
D014805:Vitamin B 12