Somatosensory seizures

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Somatosensory seizures

  1. 1. INTERESTING CASEPRESENTATION Dr. Ankit Raiyani 1st year Medicine Resident LTMGH, Sion
  2. 2. Case history Mrs. S 27 years female, R/O Diva, married, housewife Patient was asymptomatic 6 months back Patient p/w/c/o - tingling and numbness:- episodic - starting in Left LL toes - gradually progressing proximally involving whole LL - spreading upwards involving Lt UL - lasted for 4 hrs, spontaneously recovered - F/b heaviness of Lt UL & LL, lasting for whole day - 4 episodes in last 6 mths, including once in sleep ? when pt woke in night with same heaviness of limbs
  3. 3. Negative history  No h/o fever  No h/o Vx, LM  No h/o trauma, pain in neck  No h/o loss of conciousness, convulsions  Patient not a known case of HTN, DM, PTB
  4. 4. On Examination  GC- fair  P- 76/min regular  BP- 110/70 mm of Hg  No POLICE  CVS - heart sounds heard normally  P/A - soft  RS - AEBE  CNS- pt concious oriented  No focal deficit  No neck stiffness
  5. 5. Investigations  Hb- 9.3  WBC- 6800  DLC- 72/26/2/0  PLT- 214000  LFT/RFT- WNL  RBS- 89  Na/K- 138/3.4  Ca- 8.2  Mg- 2.0  Free T3/T4/TSH- 3.09/0.97/2.37
  6. 6. Inv. contd  MRI brain with epilepsy protocol with screening of cervical spine  Normal study  EEG-  Baseline beta activity in range 10-13 cps  E/o occassional bursts of sharp wave discharges  No e/o slow waves  Imp- EEG s/o seizure activity
  7. 7. Our impression Somatosensory seizure disorder
  8. 8. Treatment  Tab eptoin (100mg) tds  Tab Cal Lactate (500mg) tds  Tab Folic Acid (5mg) tds
  9. 9. Somatosensory seizures  Subtype of simple partial seizures  Focus of seizures- C/L postrolandic convolution  Sensory disorder-  Numbness, tingling, “pins & needles” feeling  Occasionally sensation of formication, electricity, movement of body parts  Rarely pain & thermal sensations
  10. 10. Somatosensory seizures  Etiology- in ~70% cases etiology can be ascertained  ICSOL, AV malformations, intra cranial hemorrhages responsible for majority cases  In 30% etiology not known
  11. 11. Somatosensory seizures  Onset of seizures-in majority cases lips, fingers, or toes  Spread to other parts follows a pattern determined by sensory arrangements in postrolandic convolution of the parietal lobe
  12. 12. Investigations  Imaging studies  CT/MRI scan  SPECT  PET scan  Functional MRI scan  Electroencephalogram
  13. 13. Treatment  Antiepilaptics  Neurosurgery
  14. 14. THANK YOU!!

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