Brain & Development 36 (2014) 411–412 www.elsevier.com/locate/braindev
Letter to the Editor Ketosis and EEG improvement following gastroenteritis in patient with West syndrome
viral
Dear Editor, Epileptic seizures generally become more serious following infections. However, in rare cases epileptic seizures, mostly in patients with West syndrome, disappear or decrease in severity after viral infection [1–3]. As Fujita et al. mention in their article entitled “Improvement of intractable childhood epilepsy following acute viral infection”, published in Brain & Development 33 (2011) 62–68, few studies have investigated the clinical manifestations or the changes in electroencephalogram (EEG) from prior to the viral infection to the resolution of epileptic seizures. The exact mechanism by which viral infection affects pathophysiology of epileptic activity is still unknown. In the same article by Fujita et al. possible mechanisms are explained [4]. We report an 11 months old female infant, with negative family history, diagnosed with West syndrome whose clinical presentation and electroencephalogram findings improved following viral gastroenteritis. Brain MRI and metabolic screening were normal. The figures show the two EEGs (before and after the infection) indicative of improvement (see Figs. 1 and 2).
Conflict of interest statement None of the authors has any conflict of interest to disclose.
References [1] Yamamoto H, Yamano T, Niijima S, Kohyama J, Yamanouchi H. Spontaneous improvement of intractable epileptic seizures following acute viral infections. Brain Dev 2004;26:377–9. [2] Hattori H. Spontaneous remission of spasms in West syndrome– implications of viral infection. Brain Dev 2001;23:705–7. [3] Yamamoto H, Kamiyama N, Murakami H, Miyamoto Y, Fukuda M. Spontaneous resolution of intractable epileptic seizures following HHV-7 infection. Brain Dev 2007;29:185–8. [4] Fujita Y, Imai Y, Ishii W, Endo A, Arakawa C, Kohira R, et al. Improvement of intractable childhood epilepsy following acute viral infection. Brain Dev 2011;33:62–8.
⇑
Anastasia Gkampeta 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, St. Kyriakidi 1, 54636 Thessaloniki, Greece ⇑Corresponding author. Tel.: +30 2310994815. E-mail address: [email protected], Efterpi Pavlidou 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, Greece
Athanasios Evangeliou 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Greece Evangelos Pavlou 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, Greece
0387-7604/$ - see front matter Ó 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.braindev.2014.01.001
412
A. Gkampeta et al. / Brain & Development 36 (2014) 411–412
Fig. 1. EEG with hypsarrhythmia and frequent generalized high-voltage poly-spikes and wave complexes (before the viral infection).
Fig. 2. EEG during and after the viral infection demonstrating infrequent spike and wave complexes without any disruption.
Letter to the Editor Ketosis and EEG improvement following gastroenteritis in patient with West syndrome
viral
Dear Editor, Epileptic seizures generally become more serious following infections. However, in rare cases epileptic seizures, mostly in patients with West syndrome, disappear or decrease in severity after viral infection [1–3]. As Fujita et al. mention in their article entitled “Improvement of intractable childhood epilepsy following acute viral infection”, published in Brain & Development 33 (2011) 62–68, few studies have investigated the clinical manifestations or the changes in electroencephalogram (EEG) from prior to the viral infection to the resolution of epileptic seizures. The exact mechanism by which viral infection affects pathophysiology of epileptic activity is still unknown. In the same article by Fujita et al. possible mechanisms are explained [4]. We report an 11 months old female infant, with negative family history, diagnosed with West syndrome whose clinical presentation and electroencephalogram findings improved following viral gastroenteritis. Brain MRI and metabolic screening were normal. The figures show the two EEGs (before and after the infection) indicative of improvement (see Figs. 1 and 2).
Conflict of interest statement None of the authors has any conflict of interest to disclose.
References [1] Yamamoto H, Yamano T, Niijima S, Kohyama J, Yamanouchi H. Spontaneous improvement of intractable epileptic seizures following acute viral infections. Brain Dev 2004;26:377–9. [2] Hattori H. Spontaneous remission of spasms in West syndrome– implications of viral infection. Brain Dev 2001;23:705–7. [3] Yamamoto H, Kamiyama N, Murakami H, Miyamoto Y, Fukuda M. Spontaneous resolution of intractable epileptic seizures following HHV-7 infection. Brain Dev 2007;29:185–8. [4] Fujita Y, Imai Y, Ishii W, Endo A, Arakawa C, Kohira R, et al. Improvement of intractable childhood epilepsy following acute viral infection. Brain Dev 2011;33:62–8.
⇑
Anastasia Gkampeta 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, St. Kyriakidi 1, 54636 Thessaloniki, Greece ⇑Corresponding author. Tel.: +30 2310994815. E-mail address: [email protected], Efterpi Pavlidou 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, Greece
Athanasios Evangeliou 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Greece Evangelos Pavlou 2nd Department of Pediatrics, Aristotle University of Thessaloniki, ‘AHEPA’ General Hospital, Greece
0387-7604/$ - see front matter Ó 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.braindev.2014.01.001
412
A. Gkampeta et al. / Brain & Development 36 (2014) 411–412
Fig. 1. EEG with hypsarrhythmia and frequent generalized high-voltage poly-spikes and wave complexes (before the viral infection).
Fig. 2. EEG during and after the viral infection demonstrating infrequent spike and wave complexes without any disruption.
