Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy.
J Neurovirol. 2018 Dec;24(6):773-775. doi: 10.1007/s13365-018-0671-z. Epub 2018 Sep 5.
Epilepsia partialis continua (EPC) is a rare entity, first described in 1894 by Koževnikov, as a variant of simple focal motor status epilepticus. EPC is most frequently characterized by motor symptoms, but as recently described, non-motor manifestations may occur, such as somatosensory symptoms or aura continua. EPC in adults has been attributed to various etiologies: infectious, vascular, neoplastic, and metabolic. According to the recent definition, we reported a case of EPC with behavioral symptoms, following a tick-borne encephalitis (TBE) contracted in an endemic area (North Eastern Italy). Patient's symptom was a poorly localized "whole body sensation", which is reported as a condition occurring only in frontal lobe epilepsy. Patient's EEG showed a left frontal predominance of epileptiform discharges. Literature highlighted the importance of the Far-eastern TBE variant as a cause of EPC, since no Western variant TBE cases are reported. In contrast to what was claimed so far, our case demonstrates that not only the Far-eastern TBE variant, but also Western variant TBE is a cause of EPC. Prognosis of EPC depends largely on the underlying etiology, and it is frequently drug-resistant. Our patient was treated with intravenous levetiracetam, with a subsequent clinical recovery and a disappearance of epileptiform discharges. The rapid clinic and electroencephalographic response to levetiracetam confirm that it can be a promising therapeutic option for treatment of EPC.
部分连续性癫痫发作（EPC）是一种罕见的病症，于 1894 年由 Koževnikov 首次描述，为简单局灶性运动性癫痫持续状态的一种变异。EPC 最常表现为运动症状，但正如最近所描述的，也可能出现非运动表现，如躯体感觉症状或持续先兆。成人 EPC 可归因于多种病因：感染性、血管性、肿瘤性和代谢性。根据最近的定义，我们报告了一例 EPC 伴有行为症状的病例，该患者在流行地区（意大利东北部）感染了蜱传脑炎（TBE）。患者的症状是一种定位不佳的“全身感觉”，这种情况仅在额叶癫痫中报告过。患者的脑电图显示左额叶癫痫样放电占优势。文献强调了远东 TBE 变异作为 EPC 病因的重要性，因为没有报告西方 TBE 变异病例。与迄今为止的说法相反，我们的病例表明，不仅远东 TBE 变异，而且西方 TBE 变异也是 EPC 的病因。EPC 的预后在很大程度上取决于潜在病因，且通常对药物治疗有抗性。我们的患者接受了静脉用左乙拉西坦治疗，随后临床恢复，癫痫样放电消失。左乙拉西坦对临床和脑电图的快速反应证实，它可能是治疗 EPC 的一种有前途的治疗选择。
