ABSTRACT
Onset of epilepsy can occur at any age, but it is relatively rare in the elderly. Late onset epilepsy is usually secondary to stroke, tumour, trauma or neurodegenerative disorders. A 62-year-old Indian woman presented with frequent drop attacks sometimes leading to unconsciousness and, rarely, associated with seizure. Her epilepsy work up was unremarkable. As the disease progressed, she was diagnosed as having idiopathic epilepsy, syncope or pseudo-seizure, on different occasions, and was treated at length with no response. Finally, detailed history-taking revealed her as having glossopharyngeal neuralgia leading to syncope and seizures. She subsequently improved. In clinical practice, such rare entities should also be considered for proper management of patients' ailments.
Subject(s)
Glossopharyngeal Nerve/pathology , Ossification, Heterotopic/complications , Ossification, Heterotopic/diagnosis , Seizures/etiology , Syncope/etiology , Temporal Bone/abnormalities , Analgesics, Non-Narcotic/therapeutic use , Anticonvulsants/therapeutic use , Carbamazepine/therapeutic use , Diagnosis, Differential , Female , Humans , Medical History Taking , Middle Aged , Ossification, Heterotopic/physiopathology , Pregabalin/therapeutic use , Temporal Bone/physiopathology , Treatment OutcomeABSTRACT
A middle aged diabetic, hypertensive, dyslipidemic, heavy alcohol consumer man came with sudden onset upper back pain and quadriparesis. Examination showed upper motor type quadriparesis with sensation of pain loss up to level of C7 and totally spared proprioception. MRI spine showed features suggestive of anterior spinal artery stroke. Can atherosclerosis be a causative factor for spinal stroke?
