1.
Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.
Errguig, L, Lahjouji, F, Belaidi, H, Jiddane, M, Elkhamlichi, A, Dakka, T, Ouazzani, R
Revue neurologique. 2013;(11):903-10
Abstract
Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features.
2.
[Adipsia and hypernatremia as the first manifestation of hypothalamic astrocytoma. Report of a case and review of the literature].
Porcar Ramells, C, Fernández-Real Lemos, JM, Camafort Babkoski, M, Ricart Engel, W
Anales de medicina interna (Madrid, Spain : 1984). 2000;(7):361-5
Abstract
Adipsia and hypernatremia is a syndrome which can be observed among children and adults with various congenital or acquired diseases of the brain. We can include the primary neoplasms and the metastatic among the causes of this syndrome. We display the case of a 63-year-old man who presented time-space disorientation, loss of memory fixation, visual hallucinations, unstable walking and absence of the voluntary ingestion of liquids. The serum electrolytes showed serum sodium concentration of 188 mEq/l with plasma osmolality above 380 mOs/kg. Both the forced water intake and the intravenous rehydration restored the plasma osmolality and the normal levels of serum sodium. The magnetic resonance (MR) neurohypophyseal area showed a neoformative lesion at the middle line which affected septum ventricular and hypothalamic area. We analyse the pathophysiologic mechanisms, the clinical and laboratory data, as well as the therapeutic and the evolution of the cases which have been published in the literature.