Epilepsy with reversible bulbar dysfunction.
In patients with focal epilepsy, focal neurological dysfunction can occur due to status epilepticus and also as a post-ictal phenomenon. Bulbar dysfunction as evident by drooling, dysarthria, swallowing difficulties, and palatal-glossalpharyngeal weakness has been reported in conjunction with epilepsy. This is non-progressive and is correlated in its severity with the frequency of seizures. Accompanying EEG discharges are often localized to rolandic areas that cortically represent oral movements and salivation. We report a 6-year-old male and a 6 1/2-year-old female with progressive bulbar dysfunction resulting from epilepsy. Ictal EEGs in patient 1 did not confirm a diagnosis of epilepsy. With no evidence of a cortical or brainstem focus from EEG or MRI, it is very difficult to explain the mechanism of bulbar dysfunction. The complete restoration of bulbar function after treatment with antiepileptic drugs demonstrates the need to consider epilepsy in similar clinical situations.
Gayatri
Neti Annapurna
NA
Department of Paediatric Neurology, Royal Manchester Children's Hospital, UK. laaligayatri@hotmail.com
Hughes
Mary Imelda
MI
Clarke
Michael Anthony
MA
Martland
Timothy Richard
TR
D000927:Anticonvulsants / Q000627:therapeutic use; D010244:Bulbar Palsy, Progressive / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000188:drug therapy; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000188:drug therapy; D019305:Epilepsy, Rolandic / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants