title: Epilepsy with reversible bulbar dysfunction.
abstract: 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.
authors.affiliation: Department of Paediatric Neurology, Royal Manchester Children's Hospital, UK. laaligayatri@hotmail.com
authors.forename: Neti Annapurna
authors.initials: NA
authors.lastname: Gayatri
authors.forename: Mary Imelda
authors.initials: MI
authors.lastname: Hughes
authors.forename: Michael Anthony
authors.initials: MA
authors.lastname: Clarke
authors.forename: Timothy Richard
authors.initials: TR
authors.lastname: Martland
mesh_terms: 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
chemical_list: D000927:Anticonvulsants