[A case of infantile epileptic apnea with congenital brain anomaly]

Tatsuyuki Ohto1, Nobuaki Iwasaki, Miho Takahashi

  • 1Department of Pediatrics, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki. tohto@md.tsukuba.ac.jp

Insights

This study reports a rare case of epileptic apnea in an infant with brain anomalies. The condition, characterized by specific EEG patterns and apnea, was successfully treated with valproate sodium.

Area of Science:

  • Neurology
  • Pediatrics
  • Epileptology

Background:

  • Apnea attacks in infants can be challenging to manage, especially when resistant to standard treatments like aminophylline.
  • Brain anomalies, such as cortical and cerebellar hypogenesis and agenesis of the corpus callosum, can present with complex neurological symptoms.

Observation:

  • A two-month-old infant with psychomotor retardation experienced aminophylline-resistant apnea attacks.
  • Video-electroencephalogram (EEG) monitoring revealed left hemispheric rhythmic delta wave bursts preceding apnea episodes.
  • During apnea, the EEG showed suppressed basic activity, indicating a link between epileptic activity and respiratory cessation.

Findings:

  • The infant was diagnosed with epileptic apnea, a rare condition associated with significant brain malformations.
  • Treatment with valproate sodium effectively controlled the apnea attacks.
  • The case highlights the potential role of specific EEG abnormalities in the pathophysiology of epileptic apnea.

Implications:

  • This case provides valuable insights into the pathomechanism of epileptic apnea, particularly in infants with congenital brain anomalies.
  • It underscores the importance of comprehensive neurophysiological investigation, including video-EEG, for diagnosing rare neurological conditions in infants.
  • The successful management with valproate sodium suggests its potential efficacy in similar cases, guiding future clinical practice.

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