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Periodic febrile confusion as a presentation of complex partial status epilepticus
1Neurology Department, Ichilov Hospital, Tel-Aviv, Israel.
Abstract:
A 75-year-old woman was evaluated for recurrent episodes of fever she experienced periodically every 4-5 weeks over the last 12 months, lasting 2-3 days each. The fever was associated with continuous complex partial seizures, paralleled the seizure activity and returned to normal after the seizures had ceased. The ictal EEG recordings showed rhythmic bitemporal 3-4 Hz activity; the interictal recordings showed a spike and wave discharge over the right fronto-temporal region. Carbamazepine effectively controlled both the seizures and the fever; the latter was presumed to be an inherent manifestation of the seizure activity.
Insights
Recurrent fevers in a 75-year-old woman were linked to complex partial seizures. Carbamazepine successfully treated both the seizures and the periodic fever episodes.
Area of Science:
- Neurology
- Epileptology
Background:
- Episodic fever can present diagnostic challenges, particularly when associated with neurological events.
- Understanding the relationship between seizure activity and systemic symptoms like fever is crucial for accurate diagnosis and treatment.
Observation:
- A 75-year-old female presented with recurrent fevers occurring every 4-5 weeks for 12 months.
- These febrile episodes coincided with complex partial seizures, with fever resolving post-seizure.
Findings:
- Electroencephalogram (EEG) revealed rhythmic bitemporal 3-4 Hz activity during seizures and right fronto-temporal spike-wave discharges interictally.
- Treatment with carbamazepine effectively controlled both the complex partial seizures and the associated fever.
Implications:
- This case suggests fever can be an ictal or postictal manifestation of complex partial seizures.
- Highlights the importance of considering seizure activity as a potential cause of recurrent fevers.
- Carbamazepine may be an effective treatment for seizure-induced fever.