Clinical characteristics, etiology and long-term outcome of epilepsia partialis continua in adult patients in Thailand

• Published in: Epilepsy research Vol. 100; no. 1; pp. 179 - 187
• Main Authors: Phabphal, Kanitpong, Limapichat, Kitti, Sathirapanya, Pornchai, Setthawatcharawanich, Suwanna, Geater, Alan
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.06.2012; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Electroencephalography - trends; Epilepsia partialis continua; Epilepsia Partialis Continua - epidemiology; Epilepsia Partialis Continua - etiology; Epilepsia Partialis Continua - physiopathology; Etiology; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Human viral diseases; Humans; Hyperglycemia - complications; Hyperglycemia - epidemiology; Hyperglycemia - physiopathology; Infectious diseases; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Outcome; Predictor; Retrospective Studies; Thailand; Thailand - epidemiology; Time; Treatment Outcome; Viral diseases; Viral diseases of the nervous system; Thailand; Asia; Thailand; Epilepsia partialis continua; Etiology; Predictor; Outcome; Human; Nervous system diseases; Prognosis; Epilepsy; Central nervous system disease; Long term; Cerebral disorder
• ISSN: 0920-1211; 1872-6844
• DOI: 10.1016/j.eplepsyres.2012.02.009

Summary Objective Epilepsia partialis continua (EPC) is clinically defined as a syndrome of continuous focal jerking of a body part. EPC has various etiologies and outcomes depending on its cause. Most studies on EPC have been conducted in Western countries and no study on the long-term outcome in adult onset epilepsia partialis continua has been reported. The aim of this study was to analyze the clinical characteristics, etiology, and treatment outcome and measurement to identify conditions that are predictive of long-term excellent outcome following epilepsia partialis continua in Thailand. Methods Our study was characterized by a retrospective systematic data collection between 2003 and 2010 that lead to the inclusion of a total of 75 patients, with epilepsia partialis continua at Songklanagarind Hospital, Thailand. All of the patients received brain CT scans or MRIs after diagnosis with EPC. Basic laboratory investigations including blood sugar, blood urea nitrogen, creatinine, electrolyte, calcium, liver function, and complete blood count tests were performed. Additionally, routine electroencephalography were performed and antiepileptic drugs were given to all patients. Therapeutic outcomes and the degree of seizure control after discharge were determined by the functional status and Seizure Frequency Scoring Systems, respectively. Key finding All of our patients manifested as motor EPC. The mean duration of EPC was 6.2 days (range 1–30 days) and the most frequent distribution of EPC involved the face and arms (42.7%). Hyperglycemia was the most common cause of EPC (34 patients, 45.3%). Fifty-one patients had an excellent outcome and 24 patients had a non-excellent outcome. All of the patients with hyperglycemia had an excellent outcome and required no antiepileptics in the long term. Predictors of excellent outcome in the scoring system for seizure frequency were metabolic or hyperglycemia-induced EPC, monotherapy and duration of EPC. Significance The characteristics of epilepsia partialis continua in this study were different from those of EPC in Western countries. Its most common cause was hyperglycemia and prognostic factors depended on etiology, number of AEDs, and duration of EPC.