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Spasticity as an ictal pattern due to excitotoxic upper motor neuron damage
C Liguori1, M G Marciani, M Albanese
1Neurophysiopathology Department, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy.
Epilepsy & Behavior : E&B
|October 30, 2012
Summary
This case report details ictal spasticity and aphasia in a patient with continuous epileptic activity. Treatment with levetiracetam led to recovery, suggesting these symptoms can be ictal manifestations.
Area of Science:
- Neurology
- Epileptology
- Neuroimaging
Background:
- Epileptic activity can manifest with diverse clinical signs.
- Ictal phenomena are typically associated with motor seizures, sensory disturbances, or altered consciousness.
Observation:
- A patient presented with spasticity and aphasia linked to continuous electroencephalographic (EEG) epileptic activity in the left frontal-temporal regions.
- Diffusion-weighted imaging (DWI) on MRI revealed restricted diffusion in the left frontal and temporal cortex.
Findings:
- Treatment with levetiracetam (3000 mg/day) resulted in progressive clinical improvement.
- EEG showed gradual disappearance of seizure activity, and MRI demonstrated resolution of restricted diffusion areas.
Implications:
- This case suggests that spasticity and aphasia can be ictal signs of epileptic seizures.
- It highlights the potential for levetiracetam in managing such presentations and underscores the utility of advanced neuroimaging in diagnosing complex epileptic phenomena.
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