Abstract
We report the unusual seizures in a patient with acute lymphoblastic leukemia. The convulsive disorder began acutely as partial somatomotor status epilepticus and with diffuse EEG slowing. The seizures then became myoclonic-atonic (drop attacks) and an EEG focus appeared on the left paramedian centro-parietal areas, activated by proprioceptive stimuli. Despite the severity of the clinical picture at onset, the seizures showed a benign course, and disappeared on carbamazepine therapy. We think that this epileptic syndrome may have been caused by diffuse iatrogenic encephalopathy, probably related to intrathecal methotrexate therapy.
Sommario
Gli Autori riportano l'inusuale semeiologia delle crisi in un bambino con una leucemia linfoblastica acuta. La sintomatologia convulsiva esordì acutamente con uno stato di male parziale somatomotorio con un rallentamento diffuso dell'EEG. Successivamente le crisi divennero di tipo mioclono-atonico (drop attacks), con comparsa di un focolaio EEG sulle aree centro-parietali paramediane di sinistra, attivato da stimoli propriocettivi.
Nonostante la gravità del quadro clinico iniziale, le crisi hanno dimostrato successivamente un andamento favorevole, con scomparsa sotto trattamento con carbamazepina.
Gli A. ipotizzano che la sindrome epilettica possa essere in rapporto ad una encefalopatia iatrogena, verosimilmente correlata con la somministrazione intratecale di metotrexate.
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Dedicated to Prof. S. Auricchio for his 60th birthday.
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Del Giudice, E., Ruosi, P., Fiorillo, A. et al. Unusual seizures with a benign course in a case of acute lymphoblastic leukemia of childhood. Ital J Neuro Sci 14, 385–389 (1993). https://doi.org/10.1007/BF02340727
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DOI: https://doi.org/10.1007/BF02340727