[Non-convulsive status epilepticus secondary to subarachnoid haemorrhage as the presenting symptom of a cerebral amyloid angiopathy].
BACKGROUND
Cerebral amyloid angiopathy is a frequent cause of haemorrhagic cerebrovascular disease in persons over the age of 65 and, sometimes, the initial symptoms can be epilepsy-like.


METHODS
A 62-year-old female with no relevant past history who was admitted to hospital due to non-convulsive status epilepticus, auditory hallucinations and ideomotor apraxia; an electroencephalogram performed on the patient revealed periodic lateralised epileptiform discharges in the right parietooccipital region. Susceptibility-weighted magnetic resonance imaging showed a sub-acute focal subarachnoid haemorrhage in the right parietotemporal region and cortico-subcortical microbleeding in different stages of the progression of the disease that were compatible with cerebral amyloid angiopathy. A critical simple single-photon emission tomography scan was performed and findings revealed an area of hyperperfusion in the same region. Antiepileptic treatment was established with clinical, neurophysiological and scintigraphic resolution.


CONCLUSIONS
The article reports a case with non-convulsive status epilepticus as the initial symptom of cerebral amyloid angiopathy. It also highlights the usefulness of sequences of susceptibility-weighted magnetic resonance imaging and the physiopathogenesis of periodic lateralised epileptiform discharges as an element of epileptic activity is discussed.
Flores-Flores
Alan
A
Servicio de Neurología, Hospital Universitari Vall d'Hebron. Barcelona, España. alanflo2507@hotmail.com
Sueiras-Gil
María
M
Toledo
Manuel
M
Garcia
Beatriz
B
Lorenzo-Bosquet
Carles
C
Rovira
Alex
A
Cuberas-Borros
Gemma
G
Auger-Acosta
Cristina
C
Salas-Puig
Javier
J
D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013226:Status Epilepticus / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants