Acute stroke-elicited epilepsia partialis continua responsive to intravenous sodium valproate.
We present an interesting case of epilepsia partialis continua (EPC) responsive to valproate treatment as an acute manifestation of cortical ischaemia in the course of vasospasm after subarachnoid bleeding A 72-year-old, right-handed woman suffering a subarachnoid haemorrhage complicated with intracerebral left hemispheric haematoma was admitted to our Department of Neurology In the disease course acute vasospasm developed, affecting the contralateral hemisphere Epilepsia partialis continua (EPC) ensued as an acute complication, with clonic jerks of the left side of the face and left upper limb This was related to epileptiform ictal activity which was followed by periodic lateralized epileptiform discharges (PLEDs) from the right frontal lobe When the standard treatment with benzodiazepines and phenytoin failed, the infusion of sodium valproate (VPA) was started This completely abolished seizure activity, bringing an improvement of the patient's neurological condition EPC may be an acute complication of cortical ischaemic damage and valproate intravenous preparation is an interesting alternative for the treatment of this poorly studied condition.
Rejdak
Konrad
K
Department of Neurology, Medical University of Lublin, Lublin. krejdak@europe.com
Papuc
Ewa
E
Dropko
Piotr
P
Stelmasiak
Zbigniew
Z
D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage*; D020520:Brain Infarction / Q000150:complications*; D004569:Electroencephalography; D017036:Epilepsia Partialis Continua / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010296:Parietal Lobe / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000150:complications; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage*; D020301:Vasospasm, Intracranial / Q000150:complications
D000927:Anticonvulsants; D014635:Valproic Acid