• Title/Summary/Keyword: Generalized tonic-clonic seizure

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A Giant Unruptured Aneurysm of Middle Cerebral Artery Bifurcation Solely Presenting with Seizure - A Case Report - (경련만으로 발현된 중대뇌동맥 분지부의 미파열성 거대 동맥류 - 증례보고 -)

  • Kim, Jae Hoon;Yi, Hyeong Joong;Kim, Kwang Myung;Kim, Jae Min;Kim, Young Soo;Ko, Yong;Oh, Seong Hoon;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.657-661
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    • 2001
  • Intracranial giant aneurysms have been known to cause clinical signs and symptoms, either by rupture, compression of surrounding structures, repeated minor leakage, or cerebral ischemia due to thromboembolism. A giant aneurysm which manifests only a seizure disorder comprises relatively few contributions. The authors present a case of a giant, unruptured aneurysm solely presenting with generalized tonic-clonic type seizure in a 43-year-old man. Brain computed tomogram(CT) and 3-D CT angiogram demonstrated a huge calcified aneurysm at the bifurcation of right middle cerebral artery. Complete neck clipping and aneurysmectomy followed by uneventful neurologic recovery.

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Status Epilepticus as a Benzodiazepine withdrawal syndrome (Benzodiazepine withdrawal syndrome에 의한 Status Epilepticus 1례)

  • Oh, Young-Min;Choi, Kyoung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.45-48
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    • 2008
  • A 57-year-old man was transferred to our emergency department with decreased mental status after organophosphate intoxication. He had a four year history of benzodiazepine and hypnotic medication use for chronic insomnia and a depressive mood disorder. He had no previous history of seizures, diabetes mellitus, and hypertension. By hospital day 5, the patient was noted to be awake and to have repetitive jerking movements involving the left upper extremity, and appeared apathetic, depressed and less responsive to external stimuli. A benzodiazepine withdrawal syndrome was subsequently apparent when he developed several generalized tonic clonic seizures and status epilepticus. Using a continuous midazolam intravenous infusion, we successfully controlled the refractory seizure without complications. We present a rare case of status epilepticus from a benzodiazepine withdrawal that developed during the treatment for organophosphate intoxication.

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A Case of Pericarditis Associated with Mycoplasma and Salmonella co-Infection (마이코플라즈마 감염과 장티프스가 병발된 심낭염 1례)

  • Koo, Gyo-Dang;Ahn, Seok-Hee;Kim, Ho-Soo;Cho, Byoung-Soo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.155-159
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    • 1997
  • We had experienced a case of pericarditis associated with Mycoplasma and Salmonella co-infection. This 5-year old boy presented with high fever and generalized tonic-clonic seizure. The diagnosis was based on the markedly increased serial titer of Widal test and cold agglutinin with Mycoplasma indirect hemmagglution test during hospitalization. The electrocardiogram revealed P-R interval prolongation and an echocardiogram revealed moderate pericardial effusion. The patient treated with ceftriaxone and erythromycin for 2 weeks, and responded to the treatment well. We report this case with brief review of the related literatures.

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Relapsed Wilms' tumor with multiple brain metastasis

  • Akakin, Akin;Yilmaz, Baran;Eksi, Murat Sakir;Yapicier, Ozlem;Kilic, Turker
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.96-98
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    • 2016
  • Wilms' tumor is the most common malignant renal tumor in childhood. The brain metastasis of a Wilms' tumor with anaplastic histopathology is rare. We present the case of an 8-year-old girl with Wilms' tumor, who presented with multiple brain metastases 5 years after her primary diagnosis. The brain masses were diagnosed after a generalized tonic-clonic seizure attack. The big solid mass in the cerebellum was resected, and whole-brain radiotherapy was performed, after which, she succumbed to her disease. In the case of clinical suspicion, cranial surveillance should be included in the routine clinical work-up for Wilms' tumor. Combined aggressive therapy (surgery+radiotherapy+chemotherapy) should be applied whenever possible, for both better survival and palliative aspects.

Disseminated Cysticercosis

  • Park, Soo-Yong;Kong, Min-Ho;Kim, Jung-Hee;Song, Kwan-Young
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.190-193
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    • 2011
  • Disseminated cysticercosis is a rare form of cysticercosis in which the cysticerci spread out through the whole body. We report the first case of a 39-year-old Mongolian with disseminated cysticercosis. He visited our hospital with generalized tonic-clonic seizure. After extensive investigation from brain computed tomography (CT), spine magnetic resonance imaging (MRI), whole body MRI and pathologic biopsy, he was diagnosed as having cysticercosis involving the brain, subcutaneous tissue, and skeletal muscles through the whole body. We treated him with the albendazole in which case the followed MRI showed that numbers of cystic lesions were copiously decreased. We report an unsual case of disseminated cysticercosis treated with medical therapy.

Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis

  • Jang, Yoon-Young;Lee, Kye-Hyang
    • Clinical and Experimental Pediatrics
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    • v.53 no.9
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    • pp.859-862
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    • 2010
  • Transient magnetic resonance (MR) signal changes in the splenium of the corpus callosum (SCC) arise from many different conditions, including encephalopathy or encephalitis caused by infection, seizures, metabolic derangements, and asphyxia. Few case reports exist on reversible SCC lesions associated with rotavirus infection. A benign convulsion with mild gastroenteritis (CwG) is frequently associated with rotaviral infections. This entity is characterized by normal laboratory findings, electroencephalogram, neuroimaging, and good prognosis. We report a case of a 2.5-year-old Korean girl with rotavirus-associated CwG demonstrating a reversible SCC lesion on diffusion-weighted MR images. She developed 2 episodes of brief generalized tonic-clonic seizure with mild acute gastroenteritis without any other neurologic abnormality. Stool test for rotavirus antigen was positive. Brain MRI done on the day of admission showed a linear high signal intensity and decreased apparent diffusion coefficient values on the SCC. The lesion completely disappeared on follow-up MRI 6 days later. The patient fully recovered without any sequelae.

A Case of Aseptic Meningitis and Unilateral Vestibulopathy Associated with Histiocytic Necrotizing Lymphadenitis(Kikuchi's disease) (조직구괴사림프절염(Kikuchi병)과 동반된 무균뇌수막염과 한쪽 전정신경병증)

  • Kim, Kyung Jib;Do, Jin Kuk;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.93-96
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    • 2007
  • A 34-year-old man presented with a severe headache, fever, and cervical lymphadenopathy followed by generalized tonic-clonic seizure. Evaluations showed splenomegaly, elevated liver enzymes, and 380 white blood $cells/mm^3$ in the cerebrospinal fluid. Two weeks after admission, he developed sudden vertigo. Examination revealed spontaneous horizontal-torsional nystagmus to the right and bithermal caloric tests documented left canal paresis. A cervical lymph node biopsy disclosed subacute necrotizing lymphadenitis. We report a case of aseptic meningitis and unilateral vestibulopathy associated with histiocytic necrotizing lymphadenitis (Kikuchi's disease).

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Laminar Cortical Necrosis (Polioencephalomalacia) caused by Postoperative Fluid Overload in a Dog with Pyometra

  • Jeong, Yoon-Soo;Kim, Ill-Hwa;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.98-102
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    • 2017
  • A 7-year-old, intact, female Siberian husky presented with vomiting and diarrhea after a fight with a dog with which it lived. The bitch was diagnosed with pyometra and severe dehydration. The patient received IV fluid therapy for 2 day pre- and post-operatively. Four days post-surgery, the patient had a decreased level of consciousness and suffered a tonic-clonic generalized seizure. On magnetic resonance imaging and histopathological findings, a diagnosis of laminar cortical necrosis caused by fluid overload was made. This case provides important information on the potential for fluid overload in a dehydrated patient giving rise to critical condition and death.

Case report of cerebral creatine deficiency syndrome with novel mutation of SLC6A8 gene in a male child in Bangladesh

  • Rahman, Muhammad Mizanur;Fatema, Kanij
    • Journal of Genetic Medicine
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    • v.18 no.1
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    • pp.44-47
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    • 2021
  • Cerebral creatine deficiency syndrome (CCDS) is a disorder where a defect is present in transport of creatine in the brain. Creatine plays an essential role in the energy metabolism of the brain. This is a genetic disorder, autosomal recessive or X linked, characterized by intellectual disability, speech and language delay, epilepsy, hypotonia, etc. Until recently very few number of cases have been reported. Here we report a case of 1.5-year-old boy who had epilepsy (epileptic spasm and generalized tonic clonic seizure), intellectual disability, microcephaly, hypotonia and speech delay. His magnetic resonance imaging of brain showed cortical atrophy and electroencephalography showed burst suppression pattern. The diagnosis was confirmed by clinical exome sequencing which showed novel mutation of SLC6A8+ in exon 9, suggestive of X linked recessive CCDS. The patient was then treated with glycine, L-arginine and creatine monohydrate with multiple antiepileptic drugs.

Successful Management of Post-Attenuation Neurologic Signs and Portal Hypertension in a Dog with Congenital Portoazygos Shunt

  • Jin-Young Kim;Kun-Ho Song;Joong-Hyun Song
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.95-100
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    • 2024
  • A 6-year-old neutered male Poodle with a body weight of 2.7 kg was diagnosed with a congenital extrahepatic portoazygos shunt presented with progressive hepatic encephalopathy. Five days after surgical attenuation, the patient showed post-attenuation neurological signs (PANS) such as generalized tonic-clonic seizure, dull mentation, and tremor. PANS were successfully managed with antiepileptic drugs, but third-space fluid accumulation (ascites and peripheral edema) and phlebectasia were newly identified, suggesting marked portal hypertension (PHT). Telmisartan, spironolactone, carvedilol, and prednisolone were sequentially administered. Three months after surgery, both abnormal clinicopathological values such as anemia and hypoalbuminemia, and clinical signs completely resolved. Herein, we report successful management strategies for PANS and PHT in a dog following surgical attenuation of a congenital portoazygos shunt.