No abstract

Eighteen adult patients with serologically confirmed West Nile virus (WNV)-associated meningitis or meningoencephalitis were admitted to our hospital during the 2000 West Nile fever outbreak in Israel. Thirteen of the patients had a more severe and prolonged clinical course, and an electroencephalogram (EEG) was, therefore, requested. A specific EEG pattern was seen in 8 patients, consisting of generalized slowing, which was more prominent over the anterior regions. Generalized slowing that was prominent over the temporal area was seen in 2 patients, and intermittent slowing over the temporal region was seen in 1 patient. Two patients had normal EEG findings. We suggest that WNV meningoencephalitis should be considered in the differential diagnosis of meningitis or meningoencephalitis with a prolonged clinical course and anteriorly predominant slowing on an EEG.

EDs in the SD-EEG following a first diagnosed seizure occur more commonly when the test is performed within 3 days following a first seizure or when previous seizures are recognized.

Five female patients with idiopathic torsion dystonia (ITD) responded to treatment with tiapride, a selective D-2 dopamine antagonist. Previous treatments with various drugs, including anticholinergics, were ineffective. It is suggested that the previously reported genetic subgroups of ITD respond to different drug regimens. The autosomal dominant group responded to anticholinergics, while the autosomal recessive group responded best to a selective D-2 dopamine antagonist.

New-generation AEDs were administered to most of the patients in this outpatient clinic-based cohort of older patients with epilepsy. In order to decrease levetiracetam-related adverse events in this age group, we suggest that a slower titration rate (e.g., an increase of ≤125 mg/day each week) and lower maximal dosage (e.g., 1500 mg/day) of the drug should be considered.