LGS and Pseudoseizure : Epilepsy.com/Professionals

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LGS and Pseudoseizure

Case Study

Editor's note: This section was sponsored by the generosity of Lundbeck. However, in order to avoid any possible sponsorship bias, the sponsor was not known to either the author or the editor.

Epilepsy Therapy Project would like to thank Lundbeck for their generosity in providing an unrestricted educational grant in support of the Lennox-Gastaut Syndrome section on professionals.epilepsy.com.

A 28 year-old mentally retarded male resident of a group home had "shakes" when he was 18 months old that required "shots". He was diagnosed with epilepsy after developing episodes where he would suddenly fall to the ground often resulting in injury. "Grand mal" seizures were prominent and refractory to multiple AEDs and the ketogenic diet. Daily episodes of staring occurred and he was brought for an opinion regarding treatment by his group home managers. Seizures and "pseudoseizures" were reported based upon bizarre "behaviors" and jerking that would occur despite being fully conscious prompting behavioral time-out" and food restriction. MRI demonstrated mild atrophy. A routine EEG revealed the following without clinical signs noted.

Figure: Interictal EEG demonstrating a 5 Hz posterior dominant rhythm with a 3 second burst of SSW-GPFA prior to an electrographic seizure (arrow). The recording parameters include a longitudinal bipolar montage with a sensitivity 7 uv and filter settings of 1-70 Hz.