A case of diffuse lupus encephalopathy successfully treated with high-dose intravenous methylprednisolone.

We report a case of systemic lupus erythematosus (SLE) in a young woman who presented a serious encephalopathy with respiratory distress and coma, after arbitrary interruption of oral corticosteroid therapy when her first pregnancy ended in abortion. The patient showed rapid improvement on methylprednisolone pulse therapy. The case suggests the utility of such a therapy in severe, non focal, CNS complications of SLE.

Brainstem auditory evoked potentials in alternating hemiplegia: ictal vs interictal assessment in one case.

The authors report a case of alternating hemiplegia (AH) in a 3yr 6m old boy who had presented, from the age of 4 months on, episodes of alternating hemi- or quadriplegia. Brainstem auditory evoked potentials were recorded both in the interictal state and, for the first time, during an attack. There was no significant difference between the two states. These findings suggest that a massive involvement of the posterior vascular territory is not likely to be associated with attacks in AH.

Benign partial epilepsy with centrotemporal (or rolandic) spikes and brain lesion.

We describe three patients with benign partial epilepsy with centrotemporal spikes (BECT) in association with proven brain lesion (agenesis of the corpus callosum, lipoma of the corpus callosum, and congenital toxoplasmosis, respectively). The age of onset, the ictal signs, the interictal electroencephalographic findings and the favorable outcome of epilepsy even after withdrawal of drug therapy led to the diagnosis of BECT although organic brain lesions were present. In such cases, the epilepsy should not be ascribed to the lesions but should be considered benign even though fortuitiously associated with brain lesions.

[Neurological manifestations of systemic lupus erythematosus. Study of 53 cases]. / Manifestazioni neurologiche nel lupus eritematoso sistemico. Studio di 53 casi.

The Authors submitted 53 randomly selected patients affected by systemic lupus erythematosus (SLE) to neurologic evaluation to investigate the prevalence of neurologic manifestations, establish relationships to clinical and epidemiological findings and antinuclear antibodies and/or lupus anticoagulant (LAC), as well as to assess the usefulness of electroencephalogram (EEG), saccadic eye movements (SEM) analysis, brain computerized tomography (CT). Twenty-two patients (41.5%) had nervous system involvement on anamnestic and/or clinical examination: there were seizures in 5 patients, headache in 3, involuntary movements in 3, psychosis in 2 and cerebrovascular disorders in 9. The patients were subdivided into 2 groups, with neuro-SLE and without neuro-SLE, according to clinical and/or anamnestic evidence of nervous system involvement. There were no differences between the two groups of patients regarding disease duration, disease activity, presence of antinuclear antibodies and/or LAC. EEG and/or SEM and/or brain CT abnormalities were found in 38 cases, 18 of which had no clinical evidence of neuro-SLE. Instrumental evaluation can thus document subtle nervous dysfunction and offers the possibility of classification into: a) non-neuro-SLE; b) subclinical neuro-SLE; c) overt neuro-SLE.

[Appearance of EEG abnormalities in two patients during long-term treatment with B vitamins]. / Apparition d'anomalies EEG chez deux patients en traitement chronique par des vitamines B.

Two female patients, one treated for epilepsy by phenobarbital (PB) and carbamazepine (CBZ), the other suffering from neurosis and free of any drug therapy, were given group B vitamins (riboflavin and nicotinic acid respectively) and showed during the long-term administration of these vitamins 2-3 Hz generalized electro-encephalographic (EEG) abnormalities. These EEG changes were detected incidentally and were not associated with any clinical manifestation; they disappeared progressively within several weeks after discontinuation of vitamin therapy. In our opinion, it is likely that the treatment with B vitamins was entirely responsible for the EEG changes, as one of the patients did not receive any other drug, while the other did not show any significant change of PB and CBZ plasma levels during vitamin therapy. However, other cases reported will be necessary to confirm our impressions.

[Interictal EEG activity specific for a particular variety of temporal epilepsy. Epileptic temporal theta rhythm]. / Une activité EEG intercritique spécifique d'une variété particulière d'épilepsie temporale. Le rythme théta temporal épileptique.

The authors stress the importance of a local theta-rhythm first described by Chatrian in 1953 and largely neglected by clinical electroencephalographers. This rhythm is constituted of waves at 3-5 c/sec; it is localised on the anterior temporal region in one hemisphere and has the same value as isolated temporal spikes or spike-waves for the diagnosis of temporal epilepsy. It furthermore presents the advantage of being specific for a particular form of temporal epilepsy of precocious appearance subsequent to a sclerosis of the anterior median temporal cortex acquired at birth or in early childhood.

An electroencephalographic demonstration of auricular reflex epilepsy.

Through electroencephalographic recording of an experimentally induced epileptic seizure, existence of the "auricular reflex epilepsy" described in about 30 reports dating from the past century is now objectively demonstrated.