Epilepsia partialis continua due to COVID-19 pneumonia

BACKGROUND

Epilepsia partialis continua (EPC) is an uncommon condition with several different etiological causes. In this article, we presented a case of EPC due to COVID-19 infection.

CASE REPORT

A 77-year-old woman with diabetes, asthma, hypertension, and chronic renal failure went to the emergency room with shortness of breath. The patient was awake and had slight hemiparesis sequela on the left due to a cerebrovascular incident 20 years earlier on neurological assessment. Non-contrast thorax computed CT revealed patchy ground-glass alveolo-acinar density increases in bilateral lung subzones, confirming COVID-19 pneumonia. After getting a positive COVID-19 PCR test, the patient was admitted to the department of infectious diseases. After a week in the hospital, seizures involving the right arm, leg, and part of the face appeared. The patient could not respond to questions. The patient's seizures lasted 12-24 hours. EEG was compatible with Epilepsia partialis continua. The cerebrospinal fluid examination was normal. Both clinical and EEG findings of the patient improved with treatment.

CONCLUSIONS

Several causes may contribute to the onset of Epilepsia partialis continua. COVID-19 infection might be one of the etiological explanations for the diagnosis of Epilepsia partialis continua and the prognosis may be very good too.

Intramedullary angioma with bilateral arm hypothermia

Spinal cavernous malformations are collections of abnormal blood vessels in the spinal cord. They are rare and frequently accompany cranial cavernous angiomas. They exhibit clinical features representing the region of the spine affected by the cavernous malformation. We present a 12-year-old boy with bilateral hypothermia predominantly in the left arm and motor weakness of the upper extremities, and lesser involvement of the lower extremities The case had normal cranial magnetic resonance imaging, but MRI of cervical region revealed an intramedullary cavernous haemangioma confirmed with histopathological examination. The lesion was totally excised and hypothermia completely improved within 2 weeks after operation. We suggested that hypothermia in the extremities may be added as a rare finding to the list of the clinical features in cervical myelopathy.

Quantitative magnetic resonance imaging of brainstem volumes, plaques, and surface area in the occipital regions of patients with multiple sclerosis

PURPOSE

To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes.

MATERIAL AND METHODS

Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated.

RESULTS

Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm3, 3515 mm3, and 4517 mm3, respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm2 in RR MS and 124.3-64.82 mm2 in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls (P < 0.01).

CONCLUSION

Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency.