Dextromethorphan in the treatment of early myoclonic encephalopathy evolving into migrating partial seizures in infancy
Journal
Journal of the Formosan Medical Association
Journal Volume
111
Journal Issue
5
Pages
290-294
Date Issued
2012
Author(s)
Abstract
Epileptic encephalopathy with suppression-burst in electroencephalography (EEG) can evolve into a few types of epileptic syndromes. We present here an unusual case of early myoclonic encephalopathy that evolved into migrating partial seizures in infancy. A female neonate initially had erratic myoclonus movements, hiccups, and a suppression-burst pattern in EEG that was compatible with early myoclonic encephalopathy. The seizures were controlled with dextromethorphan (20 mg/kg), and a suppression-burst pattern in EEG was reverted to relatively normal background activity. However, at 72 days of age, alternating focal tonic seizures, compatible with migrating partial seizures in infancy, were demonstrated by the 24-hour EEG recording. The seizures responded poorly to dextromethorphan. To our knowledge, this is the first reported case of early myoclonic encephalopathy evolving into migrating partial seizure in infancy. Whether it represents another age-dependent epilepsy evolution needs more clinical observation. ? 2012.
SDGs
Other Subjects
5 methyltetrahydrofolic acid; dextromethorphan; glycine; midazolam; phenobarbital; phenytoin; pyridoxine; article; bradycardia; case report; cerebrospinal fluid analysis; cesarean section; disease association; disease course; drug megadose; electroencephalography; evoked brain stem auditory response; female; focal epilepsy; focal tonic seizure; follow up; hiccup; hospital admission; human; hyperglycinemia; hypsarrhythmia; infant; infantile spasm; muscle hypotonia; myoclonus; nuclear magnetic resonance imaging; ophthalmoscopy; physical examination; tonic clonic seizure; treatment response; Anticonvulsants; Dextromethorphan; Disease Progression; Epilepsies, Myoclonic; Epilepsies, Partial; Female; Humans; Infant; Infant, Newborn
Type
journal article