title: Partial seizures manifesting as apnea only in an adult.
abstract: OBJECTIVE
  Although several cases of apneic seizures have been reported in neonates, epileptic seizures presenting as apnea only in adults are very rare. We present a case report of a 19-year-old man with viral encephalitis and frequent episodes of apneic seizures.
  
  
  METHODS
  Prolonged electroencephalograms (EEGs), respiratory monitorings, and imaging including ictal-interictal subtraction single photon emission computed tomography (SPECT) coregistered with magnetic resonance imaging (MRI) were performed.
  
  
  RESULTS
  Ictal EEGs recorded during apneic episodes showed repetitive sharp waves or rhythmic theta activity arising from the left or right independent bitemporal region. Ictal SPECT was performed during one episode of apnea that showed ictal EEG discharges arising from the left posterior temporal area. Ictal-interictal subtraction SPECT coregistered with MRI revealed that the seizures originated from the left, posterior, midlateral temporal cortex.
  
  
  CONCLUSIONS
  Previous studies with ictal EEG or brain stimulation suggest that apneic seizures might be mediated through the limbic and associated cortical systems. Our study reports on a very rare case of partial seizures with apnea only in an adult patient and is supported by ictal EEG and ictal-interictal subtraction SPECT coregistered with MRI.
authors.affiliation: Epilepsy Center, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Lee
authors.forename: S B
authors.initials: SB
authors.lastname: Hong
authors.forename: W S
authors.initials: WS
authors.lastname: Tae
authors.forename: D W
authors.initials: DW
authors.lastname: Seo
authors.forename: S E
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D001049:Apnea / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000706:statistics & numerical data; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000503:physiopathology; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008991:Monitoring, Physiologic; D012890:Sleep / Q000502:physiology; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data