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Published on: September 20, 2024
Epilepsia partialis continua in cat scratch disease
Monica Puligheddu1, Antonio Giagheddu, Fabrizio Genugu
1Department of Cardiovascular and Neurological Sciences, University of Cagliari, SS 554, Bivio Sestu, 09042 Monserrato, Cagliari, Italy.
Abstract:
Cat scratch disease (CSD) is a world-wide, diffuse, non-epidemic infection caused by the Gram-negative bacillus Bartonella henselae. The occurrence of encephalopathy represents an infrequent and atypical complication, whose manifestations include ischemic strokes, transverse myelitis and epileptic seizures. Status epilepticus has been described as the most frequent emergency in CSD encephalopathy. In this report, we describe a case of CSD complicated by an epilepsia partialis continua (EPC) manifested as rhythmic movements of the flexor muscles of the left hand. Although CSD is a benign, self-limited disease and a complete neurological recovery usually occurs, in the present case the EPC resulted in a partial epilepsy. Magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT) and back-averaged EEG data recorded during myoclonic activity document this CSD complication.
Insights
Cat scratch disease (CSD), a Bartonella henselae infection, can rarely cause encephalopathy. This case highlights CSD complicated by epilepsia partialis continua (EPC), a rare form of continuous partial seizures.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Cat scratch disease (CSD) is a global infection caused by Bartonella henselae.
- Encephalopathy is an uncommon complication of CSD, with status epilepticus being the most frequent neurological emergency.
- Epilepsia partialis continua (EPC) is a rare manifestation of CSD-related encephalopathy.
Observation:
- This report details a patient with CSD who developed EPC.
- The EPC presented as rhythmic left-hand flexor muscle movements.
- Diagnostic imaging included MRI, SPECT, and EEG during myoclonic activity.
Findings:
- CSD can lead to persistent partial epilepsy, even after initial recovery.
- The case documents EPC as a specific neurological complication of CSD.
- Multimodal diagnostic data confirmed the association between CSD and EPC.
Implications:
- This case expands the understanding of CSD's neurological complications.
- It emphasizes the importance of considering CSD in patients with unexplained epilepsy, particularly EPC.
- Further research may elucidate the mechanisms linking Bartonella henselae to specific seizure types.
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