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Heraldic seizure
J García-García1, S Calleja, V De la Vega
1Neurology Departament II, Hospital Universitario Central de Asturias, C/Julian Claveria s/n, 33006 Oviedo, Asturias, Spain. jggpillarno@hotmail.com
Seizure
|May 26, 2004
Summary
Heraldic seizures, or epileptic seizures preceding a stroke, can be caused by cerebrovascular disease. A case report suggests probable amyloid angiopathy may underlie these seizures and subsequent intracerebral hemorrhage.
Area of Science:
- Neurology
- Vascular Neurology
- Epileptology
Background:
- Heraldic seizures are epileptic seizures linked to cerebrovascular disease, potentially preceding a stroke.
- This concept expands understanding of epilepsy and cerebrovascular disease beyond post-stroke epilepsy.
Observation:
- A case report details a 67-year-old male with new-onset epileptic seizures preceding a lobar intracerebral hemorrhage (ICH).
- Initial presentation included myoclonic jerks and a generalized tonic-clonic seizure, with normal initial CT scan.
- Subsequent development of left hemiparesis, hemianopsia, and confusion correlated with ICH on a repeat CT scan.
Findings:
- The case exemplifies heraldic seizures, with focal seizures preceding ICH.
- Diagnostic workup suggested probable cerebral amyloid angiopathy (CAA) as the underlying etiology.
- CAA is proposed as the cause for both the ICH and the preceding seizures due to concurrent ischemia.
Implications:
- This case highlights CAA as a potential cause of heraldic seizures and ICH.
- It underscores the importance of considering cerebrovascular disease in new-onset epilepsy.
- Further research into the link between CAA, ischemia, and seizures is warranted.