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Electrical status epilepticus lasting for 17 months without behavioural changes
Abstract:
In an 8-year-old girl a seizure occurred, lasting 45 min with loss of consciousness and deviation of the eyes, 2 days after the onset of mumps. Next day the EEG showed bilateral, synchronized, continuous 2.5-3.5 c/sec spike-wave discharges, more prominent over the posterior regions. The abnormality was suppressed on eye opening and replaced by delta activity and short duration spike-wave paroxysms. Mental activity, hyperventilation, and photic stimulation did not change the pattern. The same EEG pattern persisted during daytime sleep. This picture has lasted for 17 months without any associated epileptic manifestations or behavioural disturbances. Psychometric tests and CAT scan were normal.
Insights
A prolonged seizure in an 8-year-old girl followed mumps. Her electroencephalogram (EEG) showed persistent spike-wave discharges for 17 months without seizures or behavioral issues.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Mumps is a viral illness that can occasionally cause neurological complications in children.
- Seizures are a common neurological symptom in pediatric populations.
- Electroencephalogram (EEG) is a crucial diagnostic tool for evaluating seizure activity and brain function.
Observation:
- An 8-year-old girl experienced a 45-minute seizure with loss of consciousness and eye deviation two days after mumps onset.
- Her EEG revealed continuous bilateral spike-wave discharges, particularly in posterior regions, which normalized with eye opening.
- This abnormal EEG pattern persisted for 17 months despite normal psychometric tests and CT scans, and without further epileptic events or behavioral changes.
Findings:
- The EEG findings suggest a post-infectious encephalopathy secondary to mumps, characterized by persistent generalized spike-wave discharges.
- The suppression of EEG abnormalities upon eye opening is a notable observation, differentiating it from other generalized epilepsies.
- The prolonged duration of the EEG abnormality without clinical manifestations highlights the potential for subclinical electrographic changes.
Implications:
- This case underscores the importance of EEG monitoring in children with neurological symptoms following viral infections like mumps.
- Understanding the long-term EEG patterns can help differentiate between various encephalopathic conditions and guide management strategies.
- Further research into the mechanisms of post-mumps encephalopathy and the significance of persistent subclinical EEG abnormalities is warranted.