Report of a case of neuromyelitis optica spectrum disease with symptomatic epilepsy

Neuromyelitis optica spectrum disorder(NMOSD)is a humoral immune-mediated inflammatory demyelinating disease of the central nervous system with an unclear pathogenesis,often associated with autoimmune diseases such as systemic lupus erythematosus and dry syndrome.The pathology of the disease shows demyelinating changes and axonal damage,and the lesions mostly involve the optic nerve and spinal cord,and the last region of the medulla oblongata,thalamus,paraventricular,and other sites with high aquaporin-4 expression can also be involved.The clinical manifestations are closely related to the location of the lesion,with common symptoms such as optic neuritis,acute myelitis,and intractable eruption,and most patients have recurrent episodes that can leave sequelae such as visual impairment and urinary and bowel disorders.However,a few patients present with less common symptoms,which can easily be missed or misdiagnosed,delaying the diagnosis and treatment of the disease.In this paper,we report the case of a middle-aged female patient with the first symptoms of optic neuritis who developed seizures after 2 months.After completing relevant tests,cerebrospinal fluid and serum anti-aquaporin-4 antibodies were positive,and NMOSD with symptomatic epilepsy was considered.Seizures did not recur after hormone therapy was given again.The purpose of this report is to improve awareness and diagnosis of NMOSD among clinicians.

Analysis of Etiology and Clinical Characteristics of 1170 Patients with Symptomatic Epilepsy in Jianghan Plain

Objective: The etiology, clinical manifestations and treatment of 1170 patients with symptomatic epilepsy were retrospectively analyzed and provided guidance for further treatment of symptomatic epilepsy. Method: A retrospective analysis of 1170 cases of symptomatic epilepsy admitted to the First Affiliated Hospital of Yangtze University from January 2013 to June 2018 was conducted to analyze the etiology, clinical manifestations and treatment of different age groups. Results: Symptomatic epilepsy is high in the elderly, and men are more than women. Among the 1170 patients with symptomatic epilepsy, there were 81 (6.9%) cases of brain injury, 721 (61.6%) cases of cerebrovascular disease, 223 (19.0%) cases of tumor, 59 (5.0%) cases of central nervous system infection, 33 (2.8%) cases of immune metabolic disease, 11 (0.9%) cases of drugs, 6 (0.5%) cases of cortical dysplasia, 6 (0.5%) cases of neurodegenerative disease, 4 (0.3%) cases of parasites, 4 (0.3%) cases of poisons, and 22 (1.9%) cases of other diseases. Among them, central nervous system infection and cerebrovascular disease ranked first among the patients aged 0 - 18 years, followed by immune metabolic diseases;cerebrovascular disease ranked first among the patients aged 19 - 39 years, followed by tumors and brain trauma;cerebrovascular disease ranked first among the patients aged 40 - 65 years, followed by tumors and brain trauma;cerebrovascular disease ranked first among the patients aged over 65 years, followed by tumors, among the types of seizures, 74 (6.3%) cases of tonic seizures, 68 (5.8%) cases of clonic seizures, 856 (73.2%) cases of tonic-clonic seizures, 27 (2.3%) cases of myoclonic seizures, 12 (1.0%) cases of absence seizures, 116 (9.9%) cases of complicated partial seizures, and 17 (1.5%) cases of partial seizures, in addition to the etiology, 795 (67.9%) cases of sodium valproate, 152 (13.0%) cases of carbamazepine, 56 (4.8%) cases of topiramate, 117 (10.0%) cases of levetiracetam, 23 (2.0%) cases of lamotrigine, and 27 (2.3%) cases of others were taken. Conclusion: In symptomatic epilepsy, different age groups have different causes. Among them, cerebrovascular disease, central nervous system infection, brain trauma, and brain tumor are the main causes. The most common type of seizures is the occurrence of tonic-clonic seizures. The most common drugs are sodium valproate and carbamazepine.

Treatment of symptomatic epilepsy with lesionectomies combined with bipolar coagulation of the surrounding cortex

Objective To observe the clinical effects of lesionectomies combined with bipolar coagulation of the surrounding cortex (BCSC) on symptomatic epilepsy. Methods The effectiveness of lesionectomies combined with BCSC (71 patients) and of lesionectomies alone (78 patients) were compared in follow-up surveys conducted 2-5 years (average of 37 months) post-operation.Results Treatment in the BCSC group was significantly more effective than in the lesionectomy group (P<0.01). Meanwhile, patients in the BCSC group suffered no permanent post-operative complications. Conclusion Lesionectomy combined with BCSC is a new, effective and safe treatment for symptomatic epilepsy.