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Epilepsia partialis continua following a Western variant tick-borne encephalitis

  • Lara Stragapede
  • Alessandro Dinoto
  • Marta Cheli
  • Paolo Manganotti
Case Report

Abstract

Epilepsia partialis continua (EPC) is a rare entity, first described in 1894 by Koževnikov, as a variant of simple focal motor status epilepticus. EPC is most frequently characterized by motor symptoms, but as recently described, non-motor manifestations may occur, such as somatosensory symptoms or aura continua. EPC in adults has been attributed to various etiologies: infectious, vascular, neoplastic, and metabolic. According to the recent definition, we reported a case of EPC with behavioral symptoms, following a tick-borne encephalitis (TBE) contracted in an endemic area (North Eastern Italy). Patient’s symptom was a poorly localized “whole body sensation”, which is reported as a condition occurring only in frontal lobe epilepsy. Patient’s EEG showed a left frontal predominance of epileptiform discharges. Literature highlighted the importance of the Far-eastern TBE variant as a cause of EPC, since no Western variant TBE cases are reported. In contrast to what was claimed so far, our case demonstrates that not only the Far-eastern TBE variant, but also Western variant TBE is a cause of EPC. Prognosis of EPC depends largely on the underlying etiology, and it is frequently drug-resistant. Our patient was treated with intravenous levetiracetam, with a subsequent clinical recovery and a disappearance of epileptiform discharges. The rapid clinic and electroencephalographic response to levetiracetam confirm that it can be a promising therapeutic option for treatment of EPC.

Keywords

Epilepsy TBE AEDs Epilepsia partialis continua 

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Copyright information

© Journal of NeuroVirology, Inc. 2018

Authors and Affiliations

  • Lara Stragapede
    • 1
  • Alessandro Dinoto
    • 1
  • Marta Cheli
    • 1
  • Paolo Manganotti
    • 1
  1. 1.Clinical Unit of Neurology, Department of Medicine, Surgery and Health SciencesUniversity Hospital and Health Services of Trieste, University of TriesteTriesteItaly

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