Atlas of epilepsy by Richard Appleton; D F Smith

By Richard Appleton; D F Smith

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48) and depigmented ash-leaf patches. 49). Epilepsy is invariable in learning-impaired individuals and usual in the remainder. Tuberous sclerosis is a relatively common cause of infantile spasms; later presentation is in the form of partial or generalized seizures. Tuberous sclerosis must be excluded in any child under 18 months of age who presents with both infantile spasms and partial seizures. 43 Alzheimer’s disease. Coronal section of the cerebrum at the level of the mammillary bodies shows severe cerebral atrophy, most noticeably in the superior temporal gyri, with widening of the fissures, particularly the sylvian fissures, and marked dilatation of the lateral and third ventricles.

Epilepsia 1989; 30: 389–99 Stephenson JBP. Fits and Faints. London: MacKeith Press, 1990: 103 Chadwick D. Paroxysmal disorders. In Chadwick D, Cartlidge NEF, Bates D, eds. Medical Neurology. Edinburgh: Churchill Livingstone, 1989: 152–85 Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia 2001; 42: 796–803 Waruiru C, Appleton R. Febrile seizures – an update. Arch Dis Child 2004; 89: 751–6 REFERENCES 1.

A 14-year-old boy presented with short stature, learning difficulties and epilepsy (myoclonic and generalized tonic-clonic seizures). Non-contrast axial CT shows symmetrical areas of calcification within the basal ganglia and frontal lobes. 32 Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS). Post-contrast T1-weighted MRI showing cortical enhancement in a recent posterior circulation infarct in a patient with proven MELAS. Note also the leptomeningeal enhancement which can be seen post-lumbar puncture as in this patient This is characterized by the triad of dominant inheritance, choreoathetosis and progressive dementia.

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