Cic edizioni internazionali
Clinical Cases and Reviews in Epilepsy

Post-stroke seizures: a clinical approach to diagnosis and treatment

Review, 1 - 6
doi: 10.11138/ccre/2017.2.1.001
Tag this article
Abstract
Enhanced HTML Full text PDF
Cerebrovascular disease is the most commonly identified cause of acquired epilepsy. Differentiating between early and late post-stroke seizures is relevant from an epidemiological and clinical perspective, as they carry different risk of seizure recurrence.
The occurrence of a single late post-stroke seizure is associated with high risk of seizure recurrence, and therefore enables to diagnose post-stroke epilepsy. Some clinical and stroke characteristics are associated with an increased risk of post-stroke seizures; they might prove useful in the future, when preventative measures will be available. Currently, there is no robust evidence to support the use of neuroprotective drugs for primary prevention of post-stroke seizures.
There is also insufficient evidence to recommend the use of a specific antiepileptic drug for the treatment of post-stroke epilepsy. Thrombolysis with t-PA might increase the risk of early seizures without affecting the risk of post-stroke epilepsy; further studies are however required to further investigate this association.

Psychogenic non-epileptic seizures: an overview on terminology, epidemiology and diagnostic features

Review, 7 - 14
doi: 10.11138/ccre/2017.2.1.007
Tag this article
Abstract
Enhanced HTML Full text PDF
Psychogenic non-epileptic seizures (PNES) arebparoxysmal events which may be misdiagnosedbas epileptic seizures. However, unlike epilepticbseizures, PNES are not caused by an excessive and hypersynchronous electrical activity in the brain and therefore are not accompanied by ictal electroencephalographic changes; they are common disorders, considered as an involuntary response to emotional, physical, psychological or social distress. This review focuses on terminology, epidemiology, and diagnostic difficulties
encountered by physicians facing with this condition. It also provides a comprehensive overview of the diagnostic accuracy values (sensitivity and specificity) for clinical signs commonly used to support the diagnosis of PNES.
The differential diagnosis between PNES and epileptic seizures may represent a diagnostic challenge, complicated by the coexistence of both conditions in some patients (up to 50%). The diagnostic delay for PNES is worrisome as a correct and prompt diagnosis is essential for an adequate therapy and to prevent unnecessary, costly and potentially harmful drug treatment. The diagnostic “gold standard” is a video-EEG recording of the paroxysmal event. Several physical signs have different sensitivity and specificity values in the differential diagnosis between PNES and epileptic seizures, but the diagnosis should never be driven by any single clinical sign alone. In doubtful cases, diagnosis should be carefully reconsidered checking event description and semiology at each visit, and not forgetting the possibility of a coexistence of both epilepsy and PNES.

Drug resistant epilepsy in a young male with Cat Eye Syndrome: a case study

Brief report/Clinical case, 15 - 19
doi: 10.11138/ccre/2017.2.1.015
Tag this article
Abstract
Enhanced HTML Full text PDF
The Cat Eye Syndrome (CES) is a rare syndrome associated with gains of the pericentromeric region of chromosome 22. It is usually characterized by multiorgan and physical malformation, skeletal problems, short stature, anal atresia and moderate to severe intellectual disability.
We present a case study of a 31-year-old-male affected by tetrasomy in the q11.1q11.21 region of the chromosome 22. We also carried out clinical, neurophysiological and neuroradiological evaluations, and psychometric assessment. Moreover, the patient underwent Array-CGH, conventional cytogenetic and FISH analysis.
Clinically, we observed a pulmonary venous malformation which had been surgically treated, and several physical malformations. From a neurological point of view, we observed the following characterizing elements: intellectual disability, adaptive impairment and focal epilepsy. Seizures were characterized by loss of contact, staring, face pallor, motor stereotypies such as nose scratching, bimanual automatisms, chewing and severe asthenia. As the child grew seizures became more and more frequent (up to one/two episodes a day) and were drug resistant.
Prolonged EEG recordings captured focal seizures originating on the left temporal leads.
Magnetic resonance imaging (MRI) documented thinning of the corpus callosum, hypomyelination of the semi-oval centers, extensive and multifocal subcortical malacic areas and gliosis in the brain. Although seizure characterization is lacking in CES, in the present case, paralleling anatomic defects and intellectual disability, epilepsy emerged as a main disturbance in the clinical picture of CES.

Stereotypy of psychogenic nonepileptic seizurelike events compared to temporal lobe seizures:
a quantitative analysis of ictal events captured during Video EEG monitoring

Brief report/Clinical case, 20 - 25
doi: 10.11138/ccre/2017.2.1.020
Tag this article
Abstract
Enhanced HTML Full text PDF
Objective: The overarching goal of the current study was to study the features of stereotypy in temporal lobe seizures (TLS) and psychogenic nonepileptic seizures (PNES) in four different domains: duration, type, sequence and continuity of ictal behaviours.
Methods: Video-EEG (VEEG) data from 20 TLS patients and 20 PNES patients admitted to the Stanford Epilepsy Center were retrospectively analysed. A priori, a set of 59 possible ictal behaviours was defined. Each behaviour was analysed for its duration, sequence, and continuity using quantified measures.
Results: A total of 138 seizures were analysed (90 PNES, 48 TLS). Median duration of PNES (143 s) was significantly longer than TLS (68 s) (P=0.002), and PNES exhibited greater duration variability (P=0.005). The density of “pauses” within a seizure (time-lag during which ictal behaviours cease) was significantly greater in PNES comparing to TLS (P=0.012). Moreover, the presence of 2 “pauses” during an episode determines a 69% probability of the seizure being non-epileptic, and only a 30% probability of being epileptic.
Conclusion: While different degrees of stereotypy can be seen in TLE seizures and psychogenic seizure-like events, we found that event duration and fluctuating pattern of ictal behaviour (i.e., “on-off” pattern with pauses of behaviour during ictal event) are reliable predictors of an event being psychogenic in etiology.

Super-refractory status epilepticus or degenerative encephalopathy with rapid progression?
A case report

Brief report/Clinical case, 27 - 32
doi: 10.11138/ccre/2017.2.1.027
Tag this article
Abstract
Enhanced HTML Full text PDF
Nonconvulsive status epilepticus (NCSE) may be differentiated with difficulties from acute/subacute onset encephalopathies (metabolic, toxic, postanoxic, spongiform), particularly in de novo cases. We report the case of a 57-year-old man, otherwise normal, who started to present brief focal seizures and behavioral changes few weeks after a febrile illness. At the onset, the clinical and EEG picture were suggestive of a de novo NCSE.
However, the rapid and progressive clinical and radiological worsening, the presence of a periodic EEG pattern, the drug-resistance, led us to consider a progressive degenerative encephalopathy. We report a challenging case of de novo super-refractory NCSE, without a definite etiologic diagnosis.

Polymicrogyria: the bigger the malformation, the worse the epilepsy, is that true?

Brief report/Clinical case, 33 - 36
doi: 10.11138/ccre/2017.2.1.033
Tag this article
Abstract
Enhanced HTML Full text PDF
Polymicrogyria (PMG) is a common malformation of cortical development (MCD) related to cortical organization defects, resulting in overfolding and abnormal lamination of the cortex. Epilepsy is one of the main clinical features of this syndrome, although frequency, severity and long-term outcome of seizures in these patients are not known.
We describe three patients with polymicrogyriarelated epilepsy: clinical, electroencephalographic and neuroimaging data have been analyzed. Interestingly the severity of the malformations was not correlated to the severity of epilepsy: indeed in the patient with isolated PMG the longterm outcome was poor, with severe drug-resistant epilepsy and cognitive decline, while in the patients with widespread malformations (PMG associated to nodular heterotopia, focal cortical dysplasia and other malformations of cortical development) the epilepsy outcome resulted excellent. Future studies of prognostic data in large cohorts of patients with PMG and epilepsy are needed.

Is genetic aetiology an absolute contraindication for epilepsy surgery? Description of two patients with focal genetic epilepsy who underwent presurgical study

Brief report/Clinical case, 37 - 42
doi: 10.11138/ccre/2017.2.1.037
Tag this article
Abstract
Enhanced HTML Full text PDF
In an era in which genetic panels are widely available, a growing number of lesional focal epilepsy cases, classically considered acquired, have been proven to have a genetic aetiology. Surgical anecdotal cases of focal genetic epilepsy have been reported but the prognostic value of a genetic aetiology is still uncertain, due to the lack of long follow-up data. From preliminary studies it seems that SCN1A epilepsy is associated with a bad surgical outcome, while DEPDC5 related epilepsy could be improved by a surgical approach. We reported the cases of two patients with focal epilepsy due to SCN1A and DEPDC5 mutations who underwent pre-surgical evaluation. Patient 1, despite suffering from SCN1A-related epilepsy, had a good surgical outcome, while patient 2 with DEPDC5-related focal epilepsy was unsuitable for surgery. In our opinion genetic aetiology may not be an absolute contraindication for surgery; phenotypic expression and a personalized pre-surgical workup could help to select which patients could benefit from surgery.

First clinical experiences with perampanel in adult patients with drug-resistant epilepsy and cognitive impairment

Brief report/Clinical case, 43 - 48
doi: 10.11138/ccre/2017.2.1.043
Tag this article
Abstract
Enhanced HTML Full text PDF
The aim of the present study was to evaluate the efficacy and safety of perampanel (PER) in adult patients with drug-resistant epilepsy and cognitive impairment in clinical setting. We retrospectively analyzed treatment response, seizure outcome and adverse effects of PER in thirty-three adult patients (mean age 31.6 years, range 19-55) with drug-resistant epilepsy and cognitive impairment.
PER was started with 2 mg/day at bedtime and was up-titrated by 2 mg/day every 2-4 weeks.
Evaluation was carried out after 6, 9, 12 and 18 months of PER treatment. Patients were affected by focal epilepsy (of structural, metabolic or unknown etiology) (n=19), Lennox-Gastaut syndrome (n=8), Lafora disease (n=4), generalized genetic epilepsy (n=1), Dravet syndrome (n=1).
Retention rate was 93.9% at 3 months, 81.8% at 6 months, 66.7% at 12 months. The mean PER dosage was 6.4 mg (range 2-12) at the end of follow-up. An overall improvement of seizure frequency was obtained in 48.5% of patients after 12 months, with 9 patients (21%) experiencing a greater than 50% seizure reduction. Adverse events were experienced by 51.5% patients, leading to PER discontinuation in 42% of subjects. The most common adverse events were behavioral changes (primarily aggressiveness, 24%) and
dizziness (9%). Behavioral changes were not influenced by concomitant use of other drugs, but was observed in 7 out of 11 patients with a history of behavioral problems. PER may achieve clinically improvement for a small minority of patients with adult drug-resistant heterogeneous epilepsies and intellectual disability, although few patients achieved complete seizure control. Monitoring for psychiatric adverse effects is recommended. Further studies in larger cohort with a long-term follow-up are warranting.

Surgical indication and controversies in temporal lobe epilepsy of uncertain lateralisation associated with a unilateral glioneuronal lesion: report of two cases

Brief report/Clinical case, 49 - 53
doi: 10.11138/ccre/2017.2.1.049
Tag this article
Abstract
Enhanced HTML Full text PDF
Surgery is the therapy of choice in patients with drug-resistant temporal lobe epilepsy. The best outcome is obtained when clinical data, EEG and neuroimaging correlate in pointing out a unilateral involvement. In some cases, however, seizures can arise in an apparently independent manner from both temporal lobes, featuring a bitemporal epilepsy. In these cases, patients are frequently considered not eligible for surgery.
However, several studies have shown that scalp-EEG appears not reliable in lateralizing the epileptogenic focus. On the contrary, invasive EEG has been proven able to identify a unilateral origin of seizures in more than 70% of patients who had been classified as bilateral with the non-invasive monitoring. We report two cases with similar features: drug-resistant temporal lobe epilepsy, a temporal epileptogenic lesion on brain MRI, noninvasive
Long-Term Monitoring Video-EEG evidence of seizures originating from the temporal lobe contralateral to the lesion and bilateral interictal EEG abnormalities.

Epileptic phenotypes related to the UNC79-UNC80-NALCN protein complex

Brief report/Clinical case, 54 - 58
doi: 10.11138/ccre/2017.2.1.054
Tag this article
Abstract
Enhanced HTML Full text PDF
The NALCN gene encodes a voltage-indipendent, non-selective, cation channel permeable to NA+, K+ and Ca2+ which forms a large channel complex with two other proteins, products of UNC80 and UNC79 genes.
The UNC80 gene is essential for the stability and function of the NALCN sodium leak channel and for bridging NALCN to UNC79 to form a functional complex.
This channel complex is mainly expressed in the central nervous system (CNS) and it plays a crucial role in regulating the resting membrane potentials and neuronal excitability.
Mutations in the NALCN gene have recently been linked to human diseases: two autosomal-recessive conditions (IHPRF1, Infantile hypotonia with psychomotor retardation and characteristic facies; INAD; Infantile neuroaxonal dystrophy with
facial dysmorphisms and skeletal anomalies) and one autosomal-dominant condition (CLIFHADD;
Congenital contractures of the limbs and face, hypotonia and developmental delay). Homozy - gous or compound heterozygous mutation in the UNC80 gene are associated to the IHPRF2 syndrome (Infantile hypotonia with psychomotor retardation and characteristic facies-2). In addition to facial dysmorphism and psychomotor retardation, epilepsy is often associated with IHPRF1 and IHPRF2 Syndrome but the epileptic phenotype has never been accurately described.
"Recently two novel mutations in NALCN gene have been observed in two Sardinian siblings with IHPRF1 Syndrome and epilepsy. Here we describe the epileptic phenotype of these two Sardinian siblings and compare their findings with those previously reported in
NALCN and UNC80 recessive mutated patients.

Axial propriospinal myoclonus misdiagnosed as myoclonic seizures

Brief report/Clinical case, 59 - 61
doi: 10.11138/ccre/2017.2.1.059
Tag this article
Abstract
Enhanced HTML Full text PDF
Propriospinal myoclonus is characterized by brief, repetitive, mainly arrhythmic myoclonic jerks arising from axial muscles and spreading rostrally and caudally to the adjacent myotomes. Propagation is not an obligatory feature and jerks can remain localized to the axial muscles. We present a patient with an axial non-propagated propriospinal myoclonus, misdiagnosed as myoclonic seizures, occurring at rest and at wake-sleep transition phase, and evoked by auditory and sensory stimuli. Video-polygraphic recording was
useful for a correct differential diagnosis between epileptic and nonepileptic myoclonic events.

Atypical focal ESES/CSWSS: a clinical case

Clinical trial, 62 - 65
doi: 10.11138/ccre/2017.2.1.062
Tag this article
Abstract
Enhanced HTML Full text PDF
We report an adolescent female showing the onset, at the age of 16, of tonic-clonic and focal motor seizures. The sleep EEGs disclosed continuous Spike Wave discharges occupying more than 85% of non REM sleep focalized over the left fronto-temporal regions and persisting for almost 2 years. The epileptic seizures were ultimately controlled by valproate and clobazam and the patient did not develop any cognitive impairment.
Moreover 1.5 T cerebral MRI and FDG PET were normal. We suggest that atypical cases of ESES with focal distribution, onset during adolescence and absence of cognitive impairment may be observed and need prompt recognition.

A novel de novo SCN8A mutation in an Italian child treated with Levetiracetam: a case in discussion

Brief report/Clinical case, 66 - 73
doi: 10.11138/ccre/2017.2.1.066
Tag this article
Abstract
Enhanced HTML Full text PDF
We report on a 19-months-old girl, with early onset afebrile seizures and mild developmental delay.
She presented with afebrile generalized tonicclonic seizures, after the first vaccination (Hexavalent vaccination, 5 months-old). She was referred to a child neurologist and treated with phenobarbital. The patients underwent neurological follow-up from 5 to 18 months of age. Seizures were not controlled and mild developmental delay was evident. At the age of 19 months, she presented with convulsive status epilepticus and treated with 35 mg of endorectal diazepam before admission, with subsequent cardiorespiratory failure.
She was admitted to the intensive care unit of our hospital. Interictal awake electroencephalogram (EEG) showed: activity of continuous di used theta waves with sporadic Frontal focal spikes.
After 13 days in intensive care unit the patient was moved to our child neurology ward, where she presented in a sleepiness state. EEG showed the presence of independent multifocal sharp waves, mostly frontal, epileptogenic abnormalities.
Brain magnetic resonance imaging revealed no significant abnormalities, only mild cerebral atrophy. Due to the persistence of diffuse slowing at the EEG, an immune encephalopathy was suspected and, Dexamethasone and Immunoglobulin therapy was performed, without benefit. When the patient was seizure-free, she was discharged with
Phenobarbital and Levetiracetam therapy (started in Intensive care unit). Twenty days later, at the follow-up in our Unit, the infant was significantly improved (after 3 weeks the patient was seizurefree, neurological examination showed marked improvement of gait stability and motor coordination.
Next generation sequence analysis showed a heterozygous mutation (c.4423G>A (p.Gly1475 Arg) in the SCN8A gene (Chromosome 12q13). No further seizures occurred for 3 months.
Conclusion: This report reviewed the clinical features of a patient with a de novo SCN8A mutation. Our data suggest that therapy with Phenobarbital and Levetiracetam could be effective in treating refractory epilepsy in a case with a SCN8A (c.4423G>A (p.Gly1475Arg) mutation.

Transauricular Vagus Nerve Stimulation (t-VNS) as a valid predictor of invasive VNS efficacy in drug resistant epilepsy: a case-report

Brief report/Clinical case, 74 - 79
doi: 10.11138/ccre/2017.2.1.074
Tag this article
Abstract
Enhanced HTML Full text PDF
Vagus Nerve Stimulation (VNS) is a palliative therapy for patients with drug-resistant epilepsy.
Nonetheless, no predictive factors for efficacy have been identified. Recently, a non-invasive transcutaneous VNS (t-VNS) has been developed.
It stimulates an auricular branch of the vagus nerve directed to the same nuclei of VNS. Here we report the case of a young female patient with drug-resistant epilepsy, caused by a right frontal cortical dysplasia. She had the onset of seizures at the age of 4 months, and she presented with a
West syndrome in the first year of life; in the following years, she had various types of focal seizures, with rare secondary generalization and frequent falls. She had uncountable seizures every day and a severe psychomotor delay. At the age of eight, she underwent surgery, however without benefit. At 13 years, she tested t-VNS with significant seizure reduction. Stable VNS was then implanted. Quality of life, alertness and performances of the patient improved. Even if it needs demonstration in larger case series, t-VNS could
be used to predict the effectiveness of VNS, in order to select the best candidates for a stable implant.

Super-refractory status epilepticus in children:
what happens when anesthetic therapy is not enough?

Brief report/Clinical case, 80 - 87
doi: 10.11138/ccre/2017.2.1.080
Tag this article
Abstract
Enhanced HTML Full text PDF
Introduction: to describe the clinical features, treatment options and outcome of Super-Refractory Status Epilepticus (SRSE) in a population of children aged ≤16 years with different etiology.
Methods: we retrospectively analyzed the population with status epilepticus admitted to the “Bambino Gesù” Pediatric Hospital between 2007 and 2016, identifying patients with SRSE. We examined medical history before SRSE including neurological status, preceding epilepsy, antiepileptic treatment, SE episodes. Etiology was classified as progressive/ metabolic (PM), remote symptomatic (RS), acute symptomatic (AS). We evaluated clinical and EEG features of SRSE, and all treatments including anesthetics, antiepileptic drugs and “other” treatments administered according to the single case. Outcome (further epilepsy/SE and neurological status) was assessed after ≥6 months.
Results: We identified 20 children (12 male/8 female) with SRSE with a mean age at SRSE of 5.9 years (0.7-16.6). Before SRSE 16 patients (80%) had epilepsy with episodes of SE in 8 (50%).
According to etiology 9 patients (45%) were classified as PM (8 mitochondrial, 1 folate deficiency), 7 (35%) as RS (4 genetic epilepsy, 3 focal cortical dysplasia), 4 (20%) as AS (2 CNS vasculitis, 1 stroke, 1 GABA-A receptor encephalitis). SRSE mean duration was 23 days (4-92). The most used anesthetics were midazolam (18), thiopental (15), propofol (11), ketamine (4). Treatments other than conventional AEDs were steroids (17), immunosuppressants (7), Vitamins (8), KD (5), Bromide (3), hypothermia (2), VNS (1). At last follow-up (mean 3.8 years), 12 patients (60%) showed a worsening of the neurological status, 9 (45%) presented further episodes of SE and 4 (20%) SRSE, 2 (10%) underwent epilepsy surgery and 2 (10%) died.
Significance: SRSE is a severe condition affecting mostly children with acute imbalance of the neuronal functions due to energy failure (progressive pathology), immune-mediated damage and symptomatic epilepsy; although the treatment remains
daunting, the use of “other” treatments can be very helpful in selected cases.

Ictal lateralized periodic discharges presenting as epilepsia partialis continua in a patient with chronic stroke

Brief report/Clinical case, 88 - 90
doi: 10.11138/ccre/2017.2.1.088
Tag this article
Abstract
Enhanced HTML Full text PDF
Lateralized periodic discharges (LPDs) are a frequent finding in acutely ill patients undergoing EEG recordings, but their ictal versus interictal nature is still debated. When LPDs are clearly time-locked to motor clinical manifestations, they are usually recognized as ictal and treated accordingly.
We present a case of ictal LPDs presentig as epilepsia partialis continua in a patient with poststroke frontal lobe epilepsy who was reducing antiepileptic polytherapy.

Fixation-off sensitivity in a girl with symptomatic occipital epilepsy admitted in non-convulsive status epilepticus

Brief report/Clinical case, 91 - 94
doi: 10.11138/ccre/2017.2.1.091
Tag this article
Abstract
Enhanced HTML Full text PDF
Fixation-off sensitivity occurs mainly in children with idiopathic occipital epilepsies, with only few cases reported in symptomatic epilepsies. We describe an 8-year-old girl with a history of symptomatic epilepsy admitted in non-convulsive status epilepticus. The video-EEG revealed the presence of high-amplitude occipital paroxysmal activity, which occurred continuously as long as the eyes were closed and with other conditions of fixation-off, and were inhibited when eyes were opened. Initially this phenomenon was unrecognized and misdiagnosed as simple partial status epilepticus, being treated energetically, and achieving control of discharges. We discussed the unique phenomenon of fixation-off sensitivity, which can electrically mimic an epileptic status.

Vol. 2 (No. 1) 2017 Janaury - December

  1. Post-stroke seizures: a clinical approach to diagnosis and treatment
    Brigo F., Bragazzi N.L., Nardone R.
    doi: 10.11138/ccre/2017.2.1.001
  2. Psychogenic non-epileptic seizures: an overview on terminology, epidemiology and diagnostic features
    Brigo F., Igwe S.C., Tezzon F., Nardone R.
    doi: 10.11138/ccre/2017.2.1.007
  3. Drug resistant epilepsy in a young male with Cat Eye Syndrome: a case study
    Verri A., Terzaghi M., Maffoni M., Caselli R., Recalcati M.P., Rognone E.
    doi: 10.11138/ccre/2017.2.1.015
  4. Stereotypy of psychogenic nonepileptic seizurelike events compared to temporal lobe seizures: a quantitative analysis of ictal events captured during Video EEG monitoring
    Vogrig A,, Hsiang J.C., Parvizi J.
    doi: 10.11138/ccre/2017.2.1.020
  5. Super-refractory status epilepticus or degenerative encephalopathy with rapid progression? A case report
    Pappalardo I., Cortellazzi P., de Curtis M., Didato G., Pastori C., Minardi I., Beretta S., Michelucci R., Villani F.
    doi: 10.11138/ccre/2017.2.1.027
  6. Polymicrogyria: the bigger the malformation, the worse the epilepsy, is that true?
    Mirandola L., Nobile G., Monti G., Giovannini G., Meletti S.
    doi: 10.11138/ccre/2017.2.1.033
  7. Is genetic aetiology an absolute contraindication for epilepsy surgery? Description of two patients with focal genetic epilepsy who underwent presurgical study
    Ferri L., Bisulli F., Mai R., Lichetta L., Leta C., Nobili L., Muccioli L., Mostacci B., Pippucci T., Tinuper P.
    doi: 10.11138/ccre/2017.2.1.037
  8. First clinical experiences with perampanel in adult patients with drug-resistant epilepsy and cognitive impairment
    Orlando B., Martino T., Quitadamo S.G., Di Claudio M.T., Lalla A., Avolio C., d'Orsi G.
    doi: 10.11138/ccre/2017.2.1.043
  9. Surgical indication and controversies in temporal lobe epilepsy of uncertain lateralisation associated with a unilateral glioneuronal lesion: report of two cases
    Marino D., Tumminelli G., Rocchi R., Bocci S., Pucci B., Sestini S., Cacciola F., Vatti G.
    doi: 10.11138/ccre/2017.2.1.049
  10. Epileptic phenotypes related to the UNC79-UNC80-NALCN protein complex
    Cossu S., Angius A., Oppo M., Onano S., Persico I., Persico I., Uva P., Cuccuru G., Asunis M., Crisponi L., Pruna D.
    doi: 10.11138/ccre/2017.2.1.054
  11. Axial propriospinal myoclonus misdiagnosed as myoclonic seizures
    Pascarella M.G., Martino T., Di Claudio M.T., Avolio C., d'Orsi G.
    doi: 10.11138/ccre/2017.2.1.059
  12. Atypical focal ESES/CSWSS: a clinical case
    Fatuzzo D., Giuliano L., Mainieri G., Lingenti V., Sofia V.
    doi: 10.11138/ccre/2017.2.1.062
  13. A novel de novo SCN8A mutation in an Italian child treated with Levetiracetam: a case in discussion
    Galati C., Isgrò A.R., Lo Re E., Calabrò N., Sgro D.L., Spanò M., Gagliano A.
    doi: 10.11138/ccre/2017.2.1.066
  14. Transauricular Vagus Nerve Stimulation (t-VNS) as a valid predictor of invasive VNS efficacy in drug resistant epilepsy: a case-report
    Barbella G., Freri E., Marotta G., Di Franesco J.C., Ferrarese C., Casazza M
    doi: 10.11138/ccre/2017.2.1.074
  15. Super-refractory status epilepticus in children: what happens when anesthetic therapy is not enough?
    Caputo D., Stoppa F., Vigevano F., Fusco L.
    doi: 10.11138/ccre/2017.2.1.080
  16. Ictal lateralized periodic discharges presenting as epilepsia partialis continua in a patient with chronic stroke
    Colombo M., Beretta S., Bogliun G., Ferrarese C.
    doi: 10.11138/ccre/2017.2.1.088
  17. Fixation-off sensitivity in a girl with symptomatic occipital epilepsy admitted in non-convulsive status epilepticus
    Puentes N.A., Menéndez A.G., Pérez Gil O., García Gutiérrez P.
    doi: 10.11138/ccre/2017.2.1.091
Last Viewed articles: la lista degli ultimi x visitati.
  1. Fixation-off sensitivity in a girl with symptomatic occipital epilepsy admitted in non-convulsive status epilepticus
    Puentes N.A., Menéndez A.G., Pérez Gil O., García Gutiérrez P.
    doi: 10.11138/ccre/2017.2.1.091
  2. Ictal lateralized periodic discharges presenting as epilepsia partialis continua in a patient with chronic stroke
    Colombo M., Beretta S., Bogliun G., Ferrarese C.
    doi: 10.11138/ccre/2017.2.1.088
  3. Super-refractory status epilepticus in children:
    what happens when anesthetic therapy is not enough?

    Caputo D., Stoppa F., Vigevano F., Fusco L.
    doi: 10.11138/ccre/2017.2.1.080
  4. Transauricular Vagus Nerve Stimulation (t-VNS) as a valid predictor of invasive VNS efficacy in drug resistant epilepsy: a case-report
    Barbella G., Freri E., Marotta G., Di Franesco J.C., Ferrarese C., Casazza M
    doi: 10.11138/ccre/2017.2.1.074
  5. A novel de novo SCN8A mutation in an Italian child treated with Levetiracetam: a case in discussion
    Galati C., Isgrò A.R., Lo Re E., Calabrò N., Sgro D.L., Spanò M., Gagliano A.
    doi: 10.11138/ccre/2017.2.1.066
  6. Atypical focal ESES/CSWSS: a clinical case
    Fatuzzo D., Giuliano L., Mainieri G., Lingenti V., Sofia V.
    doi: 10.11138/ccre/2017.2.1.062
credits