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Epilepsy with reversible bulbar dysfunction.

Neti Annapurna Gayatri1, Mary Imelda Hughes, Michael Anthony Clarke

  • 1Department of Paediatric Neurology, Royal Manchester Children's Hospital, UK. laaligayatri@hotmail.com

Developmental Medicine and Child Neurology
|November 7, 2002
PubMed
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Epilepsy can cause progressive bulbar dysfunction, affecting speech and swallowing. Prompt diagnosis and treatment with antiepileptic drugs can fully restore bulbar function in affected children.

Area of Science:

  • Neurology
  • Pediatric Neurology
  • Epileptology

Background:

  • Focal epilepsy can manifest with neurological dysfunction, including bulbar symptoms like drooling and swallowing difficulties.
  • These symptoms are typically non-progressive and linked to seizure frequency, often with localized EEG findings.

Observation:

  • Two pediatric cases presented with progressive bulbar dysfunction attributed to epilepsy.
  • Diagnostic challenges included inconclusive ictal EEGs and lack of clear cortical or brainstem abnormalities on EEG/MRI.

Findings:

  • Despite diagnostic uncertainties, bulbar dysfunction resolved completely with antiepileptic drug treatment.
  • This suggests a direct link between epilepsy and the observed progressive bulbar symptoms.

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Implications:

  • Highlights the importance of considering epilepsy as a cause of progressive bulbar dysfunction in children.
  • Emphasizes the diagnostic value of antiepileptic drug trials when epilepsy is suspected but not definitively proven.