[Ictal catatonia presentation as a non-convulsive status epilepticus: A case report]. / Catatonia ictal en el Servicio de Urgencia: una rara forma de presentación del estado epiléptico no convulsivo.

The differential diagnosis of non-convulsive status epilepticus (NCSE) is often complex due to a wide clinical variability of its presentation, including psychiatric manifestations. We report a 68 years old male with a history of depression treated with venlafaxine, mirtazapine, quetiapine and risperidone, presenting in the emergency room with confusion and generalized rigidity. A brain CT scan did not show lesions. A neuroleptic syndrome was initially suspected. At the third day the obtundation worsened and an electroencephalogram (EEG) was performed, which showed epileptiform abnormalities. Treatment with valproic acid resulted in disappearance of such abnormalities. After three weeks of mechanical ventilation, the patient was extubated and remained lucid and partially orientated in time and space.

Catatonia ictal en el Servicio de Urgencia: una rara forma de presentación del estado epiléptico no convulsivo / Ictal catatonia presentation as a non-convulsive status epilepticus: a case report

The differential diagnosis of non-convulsive status epilepticus (NCSE) is often complex due to a wide clinical variability of its presentation, including psychiatric manifestations. We report a 68 years old male with a history of depression treated with venlafaxine, mirtazapine, quetiapine and risperidone, presenting in the emergency room with confusion and generalized rigidity. A brain CT scan did not show lesions. A neuroleptic syndrome was initially suspected. At the third day the obtundation worsened and an electroencephalogram (EEG) was performed, which showed epileptiform abnormalities. Treatment with valproic acid resulted in disappearance of such abnormalities. After three weeks of mechanical ventilation, the patient was extubated and remained lucid and partially orientated in time and space.

Acute pontine infarct in a 16-year-old man with acute posterior multifocal placoid pigment epitheliopathy. A case report.

A 16-year-old boy recently diagnosed with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) developed an acute infarct in the left pontine region. No relevant abnormalities were found in the brain and cervical angiography, echocardiography, cerebrospinal fluid, and blood samples. Funduscopically, lesions were multiple circumscribed, creamy yellow patches, flat lesions at the level of the retinal pigment epithelium, and the fluorescence angiography confirmed an APMPPE. All visual and neurological symptoms reverted completely after use of steroid. Our patient is the youngest patient with APMPPE and stroke described so far, being the common age presentation between 20 to 40 years.