Corticosteroid-responsive Epilepsia Partialis Continua

Jayantee Kalita; Prakash Chandra Pandey; Sarvesh Kumar Chaudhary; Varun Kumar Singh; Usha Kant Misra

doi:10.4274/tnd.2020.80090

Jayantee Kalita¹, Prakash Chandra Pandey¹, Sarvesh Kumar Chaudhary¹, Varun Kumar Singh², Usha Kant Misra¹

¹Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Uttar Pradesh, India
²Institute of Medical Sciences, Banaras Hindu University, Department of Neurology, Uttar Pradesh, India

Keywords: Epilepsiya parsiyalis kontinua, refrakter epilepsi, kortikosteroid, MRG, EEG

Abstract

Epilepsia partialis continua (EPC) is a rare form of status epilepticus and often refractory to antiepileptic drugs (AEDs). Persistent seizure activity may increase pro-inflammatory biomarkers locally, which may respond to adjunctive corticosteroid treatment, especially in central nervous system (CNS) infections. We report four children with refractory EPC and the effect of adjunctive corticosteroid in controlling EPC. The duration of EPC ranged between 3 days and 7 months. One patient had secondary generalized convulsive status epilepticus. Cranial computed tomography/magnetic resonance imaging was abnormal in three out of four patients; revealing old infarction in one, tuberculoma in one, and neurocysticercosis in one. Electroencephalography revealed spike and sharp wave discharges on the corresponding cerebral hemisphere. The EPC was refractory to 2-6 AEDs. Following corticosteroid treatment, EPC remitted in two patients with CNS infection, and those with infarction and cryptogenic EPC converted to discrete seizures. In AED-resistant EPC, a short course of corticosteroid may be helpful.