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Vertebral artery dissection associated with generalized convulsive seizures: a case report
Faisal Mohammad Amin1, Vibeke Andrée Larsen, Peer Tfelt-Hansen
1Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Case Reports in Neurology
|August 2, 2013
Summary
Discontinuing lamotrigine in epilepsy patients may trigger seizures and posterior circulation issues. Vertebral artery dissection (VAD) should be considered in such cases.
Area of Science:
- Neurology
- Vascular Neurology
- Epileptology
Background:
- Juvenile myoclonic epilepsy (JME) is a common epilepsy syndrome.
- Lamotrigine is a widely used antiepileptic drug.
- Discontinuation of antiepileptic drugs can lead to seizure recurrence.
Observation:
- A 46-year-old male with JME experienced convulsive seizures post-lamotrigine discontinuation.
- Initial neurological examination revealed right hemiparesis and left-sided ataxia.
- Magnetic Resonance (MR) imaging identified a left pontine infarction, left cerebellar infarct, and right vertebral artery dissection (VAD).
Findings:
- The patient presented with acute neurological deficits following seizure exacerbation.
- Vascular imaging confirmed vertebral artery dissection as a likely cause of infarction.
- Successful treatment with anticoagulation led to excellent neurological recovery.
Implications:
- Vertebral artery dissection (VAD) is a critical consideration in patients with epilepsy experiencing posterior circulation disturbances.
- Prompt diagnosis and management of VAD can prevent severe neurological sequelae.
- This case highlights the complex interplay between epilepsy management and cerebrovascular events.
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