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Epilepsy with reversible bulbar dysfunction

Published online by Cambridge University Press:  10 October 2002

Neti Annapurna Gayatri
Affiliation:
Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK.
Mary Imelda Hughes
Affiliation:
Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK.
Michael Anthony Clarke
Affiliation:
Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK.
Timothy Richard Martland
Affiliation:
Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK.
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Abstract

In patients with focal epilepsy, focal neurological dysfunction can occur due to status epilepticus and also as a post-ictal phenomenon. Bulbar dysfunction as evident by drooling, dysarthria, swallowing difficulties, and palatal–glossalpharyngeal weakness has been reported in conjunction with epilepsy. This is non-progressive and is correlated in its severity with the frequency of seizures. Accompanying EEG discharges are often localized to rolandic areas that cortically represent oral movements and salivation. We report a 6-year-old male and a 6½-year-old female with progressive bulbar dysfunction resulting from epilepsy. Ictal EEGs in patient 1 did not confirm a diagnosis of epilepsy. With no evidence of a cortical or brainstem focus from EEG or MRI, it is very difficult to explain the mechanism of bulbar dysfunction. The complete restoration of bulbar function after treatment with antiepileptic drugs demonstrates the need to consider epilepsy in similar clinical situations.

Type
Case Reports
Copyright
© 2002 Mac Keith Press

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