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Case 48 - A Raspberry Causing Trouble

from Section 7 - Acute Onset of Neurological Symptoms

Published online by Cambridge University Press:  27 July 2023

Mark McCarron
Affiliation:
Ulster University
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Summary

A 31-year-old female primary school teacher had a post-partum tonic-clonic seizure. This was in the context of HELLP syndrome (haemolysis, elevated liver enzymes and a low platelet count).

She first developed epileptic seizures at the age of 14 years. For the next five years, she had focal seizures (right arm shaking and loss of language). Milder episodes involved a feeling of impending doom before tingling in her right hand radiated up her right arm to her right shoulder with associated dysphasia. Over a number of years, she had been tried on carbamazepine, levetiracetam and lamotrigine. Off medication she could go for up to five years with no events. When assessed on this occasion, her only medication was clobazam 10 mg/day. She did not drink alcohol or smoke cigarettes. Following this presentation she had a subsequent pregnancy, having three children in total.

Type
Chapter
Information
55 Cases in Neurology
Case Histories and Patient Perspectives
, pp. 325 - 330
Publisher: Cambridge University Press
Print publication year: 2023

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References

Munakomi, S, Torregrossa, F, Grasso, G. Natural course, clinical profile, and treatment strategies for cerebral cavernous malformations. World Neurosurg. 2022;159:373–80.CrossRefGoogle ScholarPubMed
Akers, A, Al-Shahi Salman, R, Awad, IA et al. Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the Angioma Alliance Scientific Advisory Board Clinical Experts panel. Clin Neurosurg. 2017;80(5):665–80.CrossRefGoogle ScholarPubMed
Tomson, T, Battino, D, Bonizzoni, E et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530–8.CrossRefGoogle ScholarPubMed

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