CLINICAL CASE OF PREGNANT PATIENT WITH TEMPORAL EPILEPSY AND MYOCLONIC EPILEPTIC SEIZURES
Abstract
Rationale: It is thought that temporal lobe epilepsy tends to show three types of seizures: simple partial seizures, complex partial seizures and secondary generalized motor (tonic ore tonic-clonic) seizures. Methods: Female 23-years-old patient on 12 week of pregnancy with multiple bilateral myoclonic seizures was investigated.
Results: At 4 years patient started presenting afebrile paroxysms of generalized tonic-clonic seizures from 2 to 5 times per month. For 2 years before our first meeting patient had been suffering from multiple bilateral myoclonic seizures that happened during wakefulness hundreds time per day. Patient had been treated with Carbamazepine, Phenobarbital, Fenitoin, Lamotrigine, Valproic acid in therapeutic doses without any result. On video-EEG monitoring focal epileptic activity was found in right and left temporal zones. Remission of epilepsy was reached on Clobazame 40 mg per day. The patient bore the healthy term infant through the maternal passages.
Conclusion: according to this case it becomes clear that temporal lobe epilepsy can manifest not only by focal seizures but by myoclonic seizures too. Benzodiazepines could be appropriate in treatment of such type of epilepsy. The continued epileptic seizures during pregnancy before the prescription of effective treatment aren’t the obligatory indication to cesarean section.
About the Authors
V. O. Generalov
Center for diagnosis and treatment of epilepsy “Planet Med”, Moscow
Russian Federation
Russian Federation
Generalov Vasilii Olegovich – MD, chief medical officer.
Address: Varshavskoe shosse, d. 13, Moscow, Russia, 117105.
T. R. Sadykov
Center for diagnosis and treatment of epilepsy “Planet Med”, Moscow
Russian Federation
Russian Federation
Sadykov Timur Ruslanovich – PhD, neurologist.
Address: Varshavskoe shosse, d. 13, Moscow, Russia, 117105.
N. I. Klimenchenko
Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, Moscow
Russian Federation
Russian Federation
Klimenchenko Natal’ya Ivanovna – PhD, head of the department.
Address: ul. Oparina, 4, Moscow, 117997,
A. M. Yugay
Center for diagnosis and treatment of epilepsy “Planet Med”, Moscow
Russian Federation
Russian Federation
Yugai Anton Meliksovich – neurologist.
Address: Varshavskoe shosse, d. 13, Moscow, Russia, 117105.
Yu. V. Kazakova
Center for diagnosis and treatment of epilepsy “Planet Med”, Moscow
Russian Federation
Russian Federation
Kazakova Yuliya Vladimirovna – neurologist.
Address: Varshavskoe shosse, d. 13, Moscow, Russia, 117105.
E. V. Tsalagova
Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, Moscow
Russian Federation
Russian Federation
Tsallagova Elena Vladimirovna – PhD, endocrinologist.
Address: ul. Oparina, 4, Moscow, 117997,
O. V. Shetikova
Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, Moscow
Russian Federation
Russian Federation
Shetikova Ol’ga Vladimirovna – PhD, endocrinologist.
Address: ul. Oparina, 4, Moscow, 117997,
References
1. Al-Awwad A.A., Alsuleiman B., Ng Y.T. Lateonset epilepsy with status myoclonicus: a diagnostic and management dilemma. Neurodiagn J. 2014 Mar.; 54 (1): 22-7.
2. Bergman U., Rosa F.W., Baum C. et al. Effects of exposure to benzodiazepine during fetal life. Lancet. 1992 Sep.; 340 (8821): 694-6.
3. Engel J., Pedley T.A., Aicardi J., Dichter M.A., Moshé S.L. Epilepsy: A Comprehensive Textbook. Philadelphia. 2007; 770.
4. Glauser T., Ben-Menachem E., Bourgeois B. et al. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2013 Mar.; 54 (3): 551-63.
5. Knupp K., Wirrell E. Progressive myoclonic epilepsies: it takes a village to make a diagnosis. Neurology. 2014 Feb.; 82 (5): 378-9.
6. Kobayashi K., Maniwa S., Ogino T., Yoshinaga H., Ohtsuka Y., Oka E. Myoclonic seizures combined with partial seizures and probable pathophysiology of secondary bilateral synchrony. Clin Neurophysiol. 2000 Oct.; 111 (10): 1813-1816.
7. Kubota F., Shibata N., Shiihara Y., Takahashi S., Ohsuka T. Frontal lobe epilepsy with secondarily generalized 3 Hz spike-waves: a case report. Clin Electroencephalogr. 1997 Jul.; 28 (3): 166-171.
8. Laegreid L., Olegård R., Walström J. Teratogenic effects of benzodiazepine use during pregnancy. J Pediatr. 1989 Jan.; 114 (1): 126-31.
9. Lee S.K., Hong K-S, Lee D-S. Non-lesional localization-related epilepsy. Neurology Asia. 2004. 9 (1): 43.
10. Lie O.V., Holmes M.D. Late-onset temporal lobe epilepsy in a patient with juvenile myoclonic epilepsy. Epileptic Disord. 2012 Jun.; 14 (2): 190-4.
11. Lüders H., Comair Y.G. Epilepsy surgery. Philadelphia. 2001; 1068.
12. Ornoy A., Arnon J., Shechtman S. et al. Is benzodiazepine use during pregnancy really teratogenic? Reprod Toxicol. 1998 Sep-Oct.; 12 (5): 511-5.
13. Pérault M.C., Favrelière S., Minet P. Benzodiazepines and pregnancy. Therapie. 2000 Sep-Oct.; 55 (5): 587-95.
14. Schatzberg A.F., Nemeroff C.B. The American Psychiatric Publishing Textbook of Psychopharmacology. Arlington. 2009; 1616.
15. Steegers-Theunissen R.P., Renier W.O., Borm G.F. et al. Factors influencing the risk of abnormal pregnancy outcome in epileptic women: a multi-centre prospective study. Epilepsy Res. 1994 Jul.; 18 (3): 261-9.
16. Wikner B.N., Stiller C.O., Bergman U., et al. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf. 2007 Nov.; 16 (11): 1203-10.
17. Wyllie E. The treatment of epilepsy. Principles and practice. Third edition. Philadelphia. 2001; 757.
18. Yerby M.S., Kaplan P., Tran T. Risks and management of pregnancy in women with epilepsy. Cleve Clin J Med. 2004; 71 (2): 25-37.
Review
For citations:
Generalov V.O., Sadykov T.R., Klimenchenko N.I., Yugay A.M., Kazakova Yu.V., Tsalagova E.V., Shetikova O.V. CLINICAL CASE OF PREGNANT PATIENT WITH TEMPORAL EPILEPSY AND MYOCLONIC EPILEPTIC SEIZURES. Epilepsy and paroxysmal conditions. 2015;7(2):41-48. (In Russ.)
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