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[Episodes of apnea in an infant: unusual forms of epileptic seizures]
Insights
This study describes epileptic apnea in an infant, a rare condition presenting with cyanosis and loss of consciousness. ACTH therapy successfully resolved these apneic episodes.
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Background:
- Epileptic apnea is a rare seizure manifestation, typically observed in neonates.
- This case presents a diagnostic challenge due to its occurrence in an infant beyond the neonatal period.
Observation:
- An infant developed daily episodes of epileptic apnea with cyanosis, loss of consciousness, hypotonia, and myoclonia starting at 7 months.
- Electroencephalogram (EEG) revealed a characteristic 5-7 Hz diffuse rhythm during apneic spells.
- The infant also experienced myoclonic, tonic, and partial seizures, alongside psychomotor retardation and cortico-subcortical atrophy on CT scans.
Findings:
- The observed apneic episodes were refractory to various anti-seizure medications.
- Adrenocorticotropic hormone (ACTH) therapy led to the complete resolution of the epileptic apneas.
- The study confirms the epileptic origin of these rare, late-onset apneic seizures.
Implications:
- This case highlights the importance of considering epileptic apnea in infants presenting with unexplained respiratory distress and altered consciousness.
- ACTH therapy may be a viable treatment option for refractory epileptic apnea.
- Further research is needed to understand the pathophysiology and long-term outcomes of late-onset epileptic apnea.
Abstract:
The authors report the observation of an infant who begins at the age of 7 months to present episodes of epileptic apnea with cyanosis, lost of consciousness, hypotony and sometimes ocular revulsion and distal myoclonia. From their onset there are several a day, more frequent during sleep than when awake. From the EEG point of view they are characterized by a 5-7 c/sec large and diffuse rhythm. The infant also presents epileptic myoclonias, tonic and partial seizures. She has a very slight evolutive encephalopathy, disclosed at the age of 4 months by a psychomotor retardation. No etiology has been proved. The CT scan shows during the evolution a cortico-subcortical atrophy. Every type of seizure was very resistant to different treatments. The apneas disappeared after ACTH therapy. The authors demonstrate the epileptic nature of these apneas which are very rarely observed after the neonatal period.