Gelastic seizures in a child with frontal lobe epilepsy controlled by topiramate monotherapy
- Author:
Hideo Enoki
;
Takuya Yokota
;
Mitsuyo Nishimura
;
Yuki Sasaki
;
Ayataka Fujimoto
;
Takamichi Yamamoto
- Publication Type:Journal Article
- From:Neurology Asia
2014;19(1):89-92
- CountryMalaysia
- Language:English
-
Abstract:
We report a childhood case of localization-related epilepsy manifesting frequent gelastic seizures,
which were successfully treated with topiramate (TPM) monotherapy. The seizures were not associated
with feelings of mirth. High-resolution three-tesla magnetic resonance imaging revealed no structural
abnormality. Interictal 18F-fluorodeoxyglucose positron emission tomography showed hypometabolism
over the entire right hemisphere. Single-photon emission computed tomography imaging, both ictal
and interictal, demonstrated no significant findings. Interictal electroencephalography (EEG) showed
paroxysms in the right frontal region. Ictal video EEG demonstrated diffuse attenuation, followed by
fast activities and spike-wave complexes predominantly over the right hemisphere. At the ictal EEG
onset, low amplitude paroxysmal fast activity was recorded over the F8-T4 region. The seizures were
considered to have originated from the right frontal lobe. TPM monotherapy resulted in complete
cessation of the seizure. We suggest that TPM should be considered as a valuable tool for treating
childhood intractable gelastic seizures, which are not due to hypothalamic hamartoma.
- Full text:P020150624452681335949.pdf
