Related Experiment Videos
Ictal hemiparesis
1Department of Neurology, Great Ormond Street Hospital for Children NHS Trust and Institute of Child Health, London, UK.
Insights
Ictal hemiparesis, a rare condition causing evolving limb weakness during seizures, can be diagnosed when symptoms resolve after seizure control. Normal neuroimaging is common in these cases.
Area of Science:
- Neurology
- Pediatric Neurology
- Neurophysiology
Background:
- Ictal hemiparesis is a rare neurological condition characterized by temporary weakness on one side of the body.
- It is associated with seizure activity, often presenting in children.
- The exact pathophysiology is debated but thought to involve cortical inhibition.
Observation:
- Two pediatric cases of evolving hemiparesis concurrent with seizure activity are presented.
- Structural neuroimaging was normal in both subjects.
- Electroencephalography (EEG) showed slow-wave activity, and one subject had perfusion asymmetry on SPECT scan.
Findings:
- Both children experienced complete resolution of hemiparesis following effective seizure management.
- This resolution supports the diagnosis of ictal hemiparesis.
Implications:
- The findings highlight the importance of considering ictal hemiparesis in children with evolving hemiparesis and seizure activity, especially with normal neuroimaging.
- Prompt seizure control is crucial for diagnosis and recovery.
- This condition underscores the complex relationship between seizure activity and temporary neurological deficits.
Abstract:
Two subjects with ictal hemiparesis are described. Both children presented with evolving paresis associated with seizure activity. Structural neuroimaging remained consistently normal, although EEG demonstrated slow-wave activity, and SPECT scanning in one child showed perfusion asymmetry. Both children had resolution of the hemiparesis when seizure activity was adequately controlled. The historically proposed pathophysiology of ictal hemiparesis is that of inhibition of the somatosensory and motor areas of the cortex. The presence of an evolving hemiparesis and seizure activity associated with normal neuroimaging should prompt consideration of ictal hemiparesis. Confirmation of this rare diagnosis can only be made when seizure control leads to resolution of the paresis.