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Partial status epilepticus related to independent occipital foci in posterior reversible encephalopathy syndrome (PRES)

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Abstract

Posterior reversible encephalopathy syndrome (PRES) is an acute disorder characterised by a variable association of neurologic symptoms with potentially reversible oedematous abnormalities mainly in the parieto-occipital regions of the brain. Despite the significant incidence of seizures, the EEG characteristics of epileptic disorders related to PRES have rarely been investigated. We report the case of an 85-year-old man who presented with generalised tonic-clonic seizures and prolonged disturbances of consciousness as clinical manifestations of PRES due to moderate exacerbation of chronic hypertension. An EEG performed during an alteration of mental function displayed a pattern of partial status epilepticus (SE) in both temporo-parieto-occipital regions. The seizure activity originated from two independent epileptic foci located in the occipital area of each hemisphere and could be related to the parenchymal abnormalities of PRES. The EEG pattern of partial SE related to independent occipital foci illustrates a distinctive seizure disorder that could be characteristic of PRES in adult patients.

Sommario

La sindrome della encefalopatia posteriore reversibile (PRES) è caratterizzata da una associazione di sintomi neurologici acuti (principalmente cefalea, vomito, alterazione della coscienza, crisi epilettiche e cecità corticale) e lesioni edematose potenzialmente reversibili delle regioni cerebrali parieto-occipitali. Descriviamo il caso di un soggetto maschile di 85 anni che ha manifestato crisi tonico-cloniche generalizzate ed un prolungato disturbo della coscienza come manifestazione di PRES secondaria a moderato incremento della pressione arteriosa. L’EEG ha evidenziato uno stato di male epilettico parziale legato a localizzazioni epilettogene occipitali bilaterali ed indipendenti. L’attività epilettica era correlabile alle alterazioni parenchimali della PRES. Il quadro EEGrafico osservato configura un disturbo epilettico raramente descritto nella letteratura, che potrebbe essere caratteristico della PRES in pazienti adulti.

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Authors and Affiliations

  1. Unit of Neurology, San Francesco Hospital, Via Mannironi, 08100, Nuoro, Italy

    Rosario Rossi, Maria Valeria Saddi, Anna Ticca & Salvatore Bruno Murgia

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  1. Rosario Rossi
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  2. Maria Valeria Saddi
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  3. Anna Ticca
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  4. Salvatore Bruno Murgia
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Correspondence to Rosario Rossi.

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Rossi, R., Saddi, M.V., Ticca, A. et al. Partial status epilepticus related to independent occipital foci in posterior reversible encephalopathy syndrome (PRES). Neurol Sci 29, 455–458 (2008). https://doi.org/10.1007/s10072-008-1059-2

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  • DOI: https://doi.org/10.1007/s10072-008-1059-2

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