Chapter

Case 40

Sarah Pendlebury, Ursula Schulz, Aneil Malhotra and Peter M. Rothwell

in Oxford Case Histories in TIA and Stroke

Published on behalf of Oxford University Press

Published in print January 2012 | ISBN: 9780199539345
Published online November 2012 | e-ISBN: 9780191753251 | DOI: http://dx.doi.org/10.1093/med/9780199539345.003.0245

Series: Oxford Case Histories

Case 40

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A 22-year-old man presented to the neurology clinic with poorly controlled epilepsy. The patient had been diagnosed with epilepsy at the age of 6 years. At this time, a CT brain scan had shown right frontal scarring, presumed to be due to perinatal ischaemia. He may have had generalized tonic–clonic seizures, but only very few details were available. He used to have approximately one seizure per year. More recently the patient described a change in his attacks. They consisted of his left hand shaking, sometimes associated with a feeling of his head moving up and down, light-headedness, and fatigue. An eyewitness also described occasional associated agitated behaviour. It was unclear if there was any loss of consciousness, although after an attack the patient often ‘went to sleep’ for 30 minutes. The frequency of these attacks had recently increased to one a month. Several anticonvulsants were tried, but the attack frequency remained unchanged.

Chapter.  1439 words.  Illustrated.

Subjects: Neurology

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