THE DANCE OF DOOM A RARE CASE OF EPILEPSIA PARTIALIS CONTINUA

CORRESPONDING AUTHOR:
Dr. Sakthivel Shanmugam,
No.10/10 Appavu Gramini 3rd street,
Mandaiveli, Chennai-600028,
Tamilnadu.
E-mail: sakthivelgokulam333@gmail.com

ABSTRACT: BACKGROUND: “Epilepsia Partialis Continua” is considered as the status epilepticus equivalent of simple partial motor seizures. First described by Kojewnikoff in 1894, this unique type of prolonged focal seizure continues to perplex neurologists for over a century now. Controversy looms large over the site of origin of this seizure. The unequivocal cortical origin of epilepsia partialis continua is substantiated by clinical, electrophysiologic and neurosurgical evidence. However, distant, or even subcortical sites of origin have been documented earlier. Despite our progressive knowledge about this disorder, to date, neither Antiepileptic drugs (AEDs) nor invasive/surgical treatment approaches have altered the course of this disease. We herein report a case of EPC who is admitted to our hospital. CASE REPORT: On the 31^st of July, Ms A, 20/female, educated upto XII Std, was brought to the hospital for h/o 4 episodes of seizures since morning. On examination, patient was drowsy, obeyed simple commands and largely responsive. She had persistent tachycardia         [110-130/mt], her BP -110/80 mmHg. Neurologic examination revealed left hemiparesis and left UMN 7^th nerve palsy. Her brief interictal periods [5-10mts] were punctuated by clonic seizures of left side face, upper and lower limbs [1-2mts]. She was diagnosed as “simple partial status epilepticus”. Patient’s blood investigations, CT and MRI brain were normal, EEG showed generalized abnormal seizure activity without any specific epileptogenic foci. Her Serum electrolytes and CSF studies including culture and biochemistry were normal. Patient was started and titrated sequentially on anticonvulsant polytherapy [Oral and injectables] with phenytoin, sodium valproate, carbamazepine, benzodiazepines, phenobarbitone, leviteracetam, clonazepam and clobazam. Her seizures remained uncontrolled with ongoing fits – day 93.

KEYWORDS: Epilepsia Partialis Continua, Simple Partial Status Epilepticus.