Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness

A patient with pilomotor seizures post anti‐LGI1 limbic encephalitis, refractory to immunotherapy and anti‐epileptic drugs, was investigated with electroencephalography and magnetoencephalography. Seizures occurred daily (14.9 ± 4.9/day), with catamenial exacerbation, inducible by hyperventilation....

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Autores principales: Wennberg, Richard, Maurice, Catherine, Carlen, Peter L., Garcia Dominguez, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Brief Communications
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331207/
https://www.ncbi.nlm.nih.gov/pubmed/30656195
http://dx.doi.org/10.1002/acn3.695
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author Wennberg, Richard
Maurice, Catherine
Carlen, Peter L.
Garcia Dominguez, Luis
author_facet Wennberg, Richard
Maurice, Catherine
Carlen, Peter L.
Garcia Dominguez, Luis
author_sort Wennberg, Richard
collection PubMed
description A patient with pilomotor seizures post anti‐LGI1 limbic encephalitis, refractory to immunotherapy and anti‐epileptic drugs, was investigated with electroencephalography and magnetoencephalography. Seizures occurred daily (14.9 ± 4.9/day), with catamenial exacerbation, inducible by hyperventilation. Anterior temporal ictal onsets were heralded (by ~15 sec) by high amplitude ipsilateral electromagnetic infraslow activity. The catamenial/ventilatory sensitivity and the infraslow activity (reflecting glial depolarization) suggested an ionic, CO (2)/pH‐related glioneuronal mechanism. Furosemide decreased seizure frequency by ~33%. Acetazolamide led to immediate seizure freedom, but lost efficacy with daily treatment. A cycling acetazolamide regimen (2 days on, 4 days off) plus low‐dose topiramate maintained >95% reduction (0.5 ± 0.9/day) in seizures.
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spelling pubmed-63312072019-01-17 Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness Wennberg, Richard Maurice, Catherine Carlen, Peter L. Garcia Dominguez, Luis Ann Clin Transl Neurol Brief Communications A patient with pilomotor seizures post anti‐LGI1 limbic encephalitis, refractory to immunotherapy and anti‐epileptic drugs, was investigated with electroencephalography and magnetoencephalography. Seizures occurred daily (14.9 ± 4.9/day), with catamenial exacerbation, inducible by hyperventilation. Anterior temporal ictal onsets were heralded (by ~15 sec) by high amplitude ipsilateral electromagnetic infraslow activity. The catamenial/ventilatory sensitivity and the infraslow activity (reflecting glial depolarization) suggested an ionic, CO (2)/pH‐related glioneuronal mechanism. Furosemide decreased seizure frequency by ~33%. Acetazolamide led to immediate seizure freedom, but lost efficacy with daily treatment. A cycling acetazolamide regimen (2 days on, 4 days off) plus low‐dose topiramate maintained >95% reduction (0.5 ± 0.9/day) in seizures. John Wiley and Sons Inc. 2018-11-12 /pmc/articles/PMC6331207/ /pubmed/30656195 http://dx.doi.org/10.1002/acn3.695 Text en © 2018 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Brief Communications
Wennberg, Richard
Maurice, Catherine
Carlen, Peter L.
Garcia Dominguez, Luis
Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title_full Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title_fullStr Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title_full_unstemmed Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title_short Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
title_sort pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
topic Brief Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331207/
https://www.ncbi.nlm.nih.gov/pubmed/30656195
http://dx.doi.org/10.1002/acn3.695
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