Fernández-Torre José L, Riancho Javier, Martín-García María, Martínez-de Las Cuevas Gonzalo, Bosque-Varela Pilar
Department of Clinical Neurophysiology, Marqués de Valdecilla University Hospital, Santander, Department of Physiology and Pharmacology, University of Cantabria (UNICAN), Santander, Biomedical Research Institute (IDIVAL).
Department of Physiology and Pharmacology, University of Cantabria (UNICAN), Santander, Biomedical Research Institute (IDIVAL).
Epileptic Disord. 2019 Feb 1;21(1):92-96. doi: 10.1684/epd.2019.1031.
Generalized tonic status epilepticus (TSE) is a rare epileptic condition. It occurs usually in the context of symptomatic generalized epilepsy, in particular, in subjects with a diagnosis of Lennox-Gastaut syndrome, atypical forms of idiopathic (genetic) generalized epilepsy, or as a paradoxical effect during treatment with diverse antiepileptic drugs. Herein, we describe the case of an elderly woman on chronic treatment with psychotropic drugs who developed an episode of generalized TSE. Motor manifestations were subtle and difficult to recognize as seizures, and a detailed video-EEG importantly contributed to accurate and prompt diagnosis. TSE was initially refractory to conventional anti-seizure drug therapy including levetiracetam and valproate but was finally controlled with lacosamide. Our case indicates a potential therapeutic effect of lacosamide on TSE in the elderly after treatment failure with first-line anti-seizure drugs. [Published with video sequence on www.epilepticdisorders.com].
全身性强直癫痫持续状态（TSE）是一种罕见的癫痫病症。它通常发生在症状性全身性癫痫的背景下，特别是在诊断为Lennox-Gastaut综合征、非典型特发性（遗传性）全身性癫痫的患者中，或者作为使用多种抗癫痫药物治疗期间的一种矛盾效应。在此，我们描述了一名长期接受精神药物治疗的老年女性发生全身性TSE发作的病例。运动表现较为隐匿，难以识别为癫痫发作，详细的视频脑电图对准确及时的诊断起到了重要作用。TSE最初对包括左乙拉西坦和丙戊酸盐在内的传统抗癫痫药物治疗无效，但最终用拉科酰胺得到了控制。我们的病例表明，在一线抗癫痫药物治疗失败后，拉科酰胺对老年TSE患者具有潜在的治疗效果。[已在www.epilepticdisorders.com上发布视频序列]
