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Overview of Epilepsia Partialis Continua

     

Epilepsia partialis continua (EPC) was first described by Kozhevnikov so it is also called as Kozhevnikov syndrome. Epilepsia partialis continua is brain disorder which consist of continuous focal jerking movements of a body part which lasts for over a period of hours, days or even years. It is focal motor type of seizure or focal motor status epilepticus. Occurrence of EPC is very rare and attack mainly involves Facial and limb muscles. It may occur at any age but mostly common in children and senior persons. Along with EPC other types of seizure such as secondarily generalized tonic-clonic seizures or complex partial seizures may also occurred. Seizures also continue during sleep but may be at slow down rate. During seizure conscious is preserved in almost all cases.

Causes for Epilepsia partialis continua

  • Causes for children-Kozhevnikov-Rasmussen syndrome is mainly responsible for causing EPC in children.
    Focal or multifocal brain lesions, systemic diseases and metabolic-toxic and developmental errors may give rise to EPC.
  • Causes for adults-Cerebrovascular accident and brain lesions which result from stroke are the main causes in adults.
  • Non-ketotic hyperglycemia is the most common cause for EPC.
  • In some cases cause remains unknown.
  • Genetics, chronic viral infections, brain tumors, demyelization disorders may cause EPC.

Exams and Tests for Epilepsia partialis continua

  1. EEG shows discrete spikes, sharp waves, or slow-wave activity
  2. CT and MRI scan are helpful which shows affected area of brain.
  3. PET and SPECT scans are helpful to identify the abnormal region.
  4. Sometimes screening of metabolic and mitochondrial disorders also required.

Treatment for Epilepsia partialis continua

Epilepsia partialis continua is a resistant to treatment. You can only reduce further seizure by treatment. Treatment generally depends on cause found in EPC.

  • Antimyoclonic drugs such as piracetam, ethosuximide and benzodiazepines may prescribe by doctor.
  • Phenytoin or phenobarbital is more effective to reduce seizure.
  • Clonazepam, carbamazepine, valproate or levetiracetam can use to treat.
  • Oral corticosteroid therapy and immunosuppression is used in rare case.
  • Plasma exchange and transcranial magnetic stimulation is helpful to improve EPC.