1. Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness.
- Author
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Wennberg, Richard, Maurice, Catherine, Carlen, Peter L., and Garcia Dominguez, Luis
- Subjects
HYPERVENTILATION ,ENCEPHALITIS ,FUROSEMIDE ,IMMUNOTHERAPY ,ACETAZOLAMIDE - Abstract
A patient with pilomotor seizures post anti‐LGI1 limbic encephalitis, refractory to immunotherapy and anti‐epileptic drugs, was investigated with electroencephalography and magnetoencephalography. Seizures occurred daily (14.9 ± 4.9/day), with catamenial exacerbation, inducible by hyperventilation. Anterior temporal ictal onsets were heralded (by ~15 sec) by high amplitude ipsilateral electromagnetic infraslow activity. The catamenial/ventilatory sensitivity and the infraslow activity (reflecting glial depolarization) suggested an ionic, CO2/pH‐related glioneuronal mechanism. Furosemide decreased seizure frequency by ~33%. Acetazolamide led to immediate seizure freedom, but lost efficacy with daily treatment. A cycling acetazolamide regimen (2 days on, 4 days off) plus low‐dose topiramate maintained >95% reduction (0.5 ± 0.9/day) in seizures. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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