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Prolonged epileptic blindness in an infant associated with cortical dysplasia

Published online by Cambridge University Press:  14 February 2001

Eli Shahar
Affiliation:
Child Neurology Unit, Rambam Medical Center, Haifa, Israel.
Paul A Hwang
Affiliation:
Division of Neurology, Hospital for Sick Children,Toronto, Canada.
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Abstract

We report a female infant with status epilepticus amauroticus and intractable focal motor seizures associated with congenital cortical dysplasia. EEG demonstrated persistent epileptiform discharges over the right parieto-temporal regions extending to occipital areas. She required cortical resection of the epileptic zone at age 8 months given failure of very high dose antiepileptic combinations. Histological analysis of a sample of cortex resected from the right central parieto-temporal region, identified by electrocorticography as the focus of epileptic activity, showed cortical dysplasia. The seizures ceased and the infant gained full vision after 48 hours. During an 8-year follow-up period she has had a few short-lived seizures, currently controlled with carbamazepine and vigabatrin. Her cognition and speech are intact. This case demonstrates that: (1) resection of a central temporo-parietal focus, which may have spread to the occipital regions, may result in complete visual recovery and cessation of seizures; and (2) EEG should be considered in every infant with alleged delayed visual maturation, to rule out concealed epileptic activity.

Type
Case Reports
Copyright
© 2000 Mac Keith Press

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