Abstract
A 80-year-old man with cobalamin deficiency and no history of epilepsy developed a partial complex epileptic confusional status (ECS) unresponsive to acute i.v. diazepam. Brain CT scan and MRI investigation ruled out a focal cerebral lesion. Therapy with high doses (10,000 μg i.m. daily) of cobalamin alone was started, and the patient fully recovered in the following 72-hour. Control EEGs repeatedly performed days and weeks later showed progressive disappearance of the frontal interictal spiking, while the patient was on monotherapy with cobalamin (5,000 μg i.m. weekly). A month later the patient unfortunately discontinued replacement therapy and 13 weeks later he developed a fatal convulsive epileptic status. To our knowledge the association of ECS and cobalamin-deficiency has not been previously reported.
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Aguglia, U., Gambardella, A., Oliveri, R.L. et al. De novo epileptic confusional status in a patient with cobalamin deficiency. Metab Brain Dis 10, 233–238 (1995). https://doi.org/10.1007/BF02081028
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DOI: https://doi.org/10.1007/BF02081028