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Citation
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Aboseif A, Maly EF, Syed FH, Punia V, Kunchok A, Abbatemarco JR. Pract. Neurol. 2024; ePub(ePub): ePub. |
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Abstract
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Case presentation
A 29-year-old man presented to the emergency department after a motor vehicle collision, with aphasia, perseveration and no memory of the events leading up to the crash. His serum lactate was elevated, plasma glucose was normal, and urine toxicology was negative. CT scans of the head and neck were normal. He was thought to have had a first-time seizure and was discharged with a neurology follow-up.
One week later, he had an episode of aphasia and headache, progressing to a focal-to-bilateral tonic-clonic seizure, which resolved with lorazepam. There were no clear risk factors for epilepsy, and there was no personal or family history of seizures. On examination, he had fluctuating aphasia, right-sided neglect, right-hand apraxia, finger agnosia, acalculia and right-left confusion. An MR scan of the brain without contrast 6 days after symptom onset was normal (figure 1A). He was started on levetiracetam before discharge home.
Language: en |