Adult onset seizures in learning disability
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We report two cases of adults presenting with transient loss of consciousness (TLoC) followed by a rapid recovery. Careful history taking revealed a stereotyped prodrome of déjà vu, raising the possibility of these events being focal seizures rather than syncope. The patients were commenced on antiepileptic drugs (AEDs) at the same time as having cardiac monitoring organised. This confirmed asystole during the seizure symptoms, resulting in TLoC.
Clinical and basic research in paediatric epilepsy continues to have a direct impact on the diagnosis and treatment of children with seizures. In recent years, advances in molecular biology are beginning to unravel the molecular processes underlying childhood epilepsy, and there is increased understanding of the role of ion channels (and their interacting proteins) in the pathophysiology of epilepsy. Clinical trials and Cochrane reviews of diagnosis, treatment and outcome have also contributed to the management of paediatric epilepsy.
Posterior reversible encephalopathy syndrome (PRES) is a combined clinical and radiological syndrome characterised by headaches, encephalopathy, seizures and visual loss. We present the case of a 55-year-old male who developed this condition following treatment with deoxycoformycin and alemtuzumab. We review the literature considering diagnosis, pathophysiology and optimal strategies for treatment of this condition.
Keywords Chemotherapeutic agents, encephalopathy, headache, PRES, seizures