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Neuropsychiatric porphyria in patients with refractory epilepsy: report of three cases
A S Winkler1, T J Peters, R D C Elwes
1Department of Clinical Biochemistry, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Objectives:
Although epileptic seizures are an infrequent feature of acute attacks of the neuropsychiatric porphyrias, there are no significant reports of porphyria in chronic epilepsy. This paper attempts to redress the balance.
Methods:
Three case reports, including detailed laboratory and molecular diagnostics.
Results:
Two patients with variegate porphyria and one with acute intermittent porphyria, referred within 1 year to a specialist porphyria service, with a long history of chronic refractory epileptic seizures, are described.
Conclusions:
Porphyria may be an aetiological factor in some cases of chronic refractory partial or generalised epilepsy. Porphyria should also be considered if addition of a new anti-epileptic medication causes a major deterioration in the epilepsy.
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Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Hepatic Encephalopathy
