RESUMEN
Peri-ictal water drinking (PIWD) is a rare vegetative manifestation of temporal lobe epilepsy without a definite lateralisation value. We report a case of PIWD in a 22-year-old Omani male patient with post-concussion syndrome and epilepsy presented to a tertiary care hospital in Muscat, Oman, in 2021 for evaluation of paroxysmal events. His behaviour of PIWD was misinterpreted by his family until characterised in the epilepsy-monitoring unit as a manifestation of epilepsy that was treated medically. To the best of the authors' knowledge, this is the second reported case in the region.
Asunto(s)
Epilepsia del Lóbulo Temporal , Humanos , Masculino , Omán , Adulto Joven , Epilepsia del Lóbulo Temporal/fisiopatología , Ingestión de Líquidos/fisiología , Esclerosis , Electroencefalografía/métodos , Esclerosis del HipocampoRESUMEN
Restructuring of healthcare services during the COVID-19 pandemic has led to lockdown of Epilepsy Monitoring Units (EMUs) in many hospitals. The ad-hoc taskforce of the International League Against Epilepsy (ILAE) and the International Federation of Clinical Neurophysiology (IFCN) highlights the detrimental effect of postponing video-EEG monitoring of patients with epilepsy and other paroxysmal events. The taskforce calls for action to continue functioning of Epilepsy Monitoring Units during emergency situations, such as the COVID-19 pandemic. Long-term video-EEG monitoring is an essential diagnostic service. Access to video-EEG monitoring of the patients in the EMUs must be given high priority. Patients should be screened for COVID-19, before admission, according to the local regulations. Local policies for COVID-19 infection control should be adhered to during the video-EEG monitoring. In cases of differential diagnosis where reduction of antiseizure medication is not required, consider home video-EEG monitoring as an alternative in selected patients.
Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/normas , Electroencefalografía/normas , Epilepsia/diagnóstico , Accesibilidad a los Servicios de Salud/normas , Neurofisiología/normas , COVID-19/epidemiología , Control de Enfermedades Transmisibles/métodos , Consenso , Electroencefalografía/métodos , Epilepsia/epidemiología , Epilepsia/fisiopatología , Humanos , Internacionalidad , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/normas , Neurofisiología/métodosRESUMEN
Restructuring of healthcare services during the COVID-19 pandemic has led to lockdown of epilepsy monitoring units (EMUs) in many hospitals. The ad-hoc taskforce of the International League Against Epilepsy (ILAE) and the International Federation of Clinical Neurophysiology (IFCN) highlights the detrimental effect of postponing video-EEG monitoring of patients with epilepsy and other paroxysmal events. The taskforce calls for action for continued functioning of EMUs during emergency situations, such as the COVID-19 pandemic. Long-term video-EEG monitoring is an essential diagnostic service. Access to video-EEG monitoring of the patients in the EMUs must be given high priority. Patients should be screened for COVID-19, before admission, according to the local regulations. Local policies for COVID-19 infection control should be adhered to during the video-EEG monitoring. In cases of differential diagnosis in which reduction of antiseizure medication is not required, home video-EEG monitoring should be considered as an alternative in selected patients.
Asunto(s)
COVID-19 , Consenso , Electroencefalografía , Epilepsia , Accesibilidad a los Servicios de Salud , Monitorización Neurofisiológica , Servicio Ambulatorio en Hospital , COVID-19/diagnóstico , COVID-19/prevención & control , Electroencefalografía/normas , Epilepsia/diagnóstico , Epilepsia/terapia , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/normas , Humanos , Monitorización Neurofisiológica/normas , Servicio Ambulatorio en Hospital/organización & administración , Servicio Ambulatorio en Hospital/normas , Sociedades Médicas/normasRESUMEN
BACKGROUND Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome. CASE REPORT Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke. CONCLUSIONS VBD is a complex arterial disease with a variety of clinical manifestation, with bilateral ophthalmoplegia being a rare presentation. Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient.