Complex partial status epilepticus of extratemporal origin in a patient with systemic lupus erythematosus

Abstract

The purpose of this case report is to describe the clinical, electroencephalographic and neuroimaging findings from a woman with systemic lupus erythematosus presenting with complex partial status epilepticus (CPSE) of neocortical temporo-parieto-occipital origin. The patient experienced complex visual hallucinations that initially were attributed to treatment with corticosteroids; however, an electroencephalogram (EEG) demonstrated the epileptic aetiology of her symptoms. CPSE should be considered as a possible cause of altered mental status in lupus. An urgent EEG is essential to make an accurate diagnosis.

Clinical, laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the nervous system

“…In our series, 3 of the 17 (17.6%) patients with seizures had one episode of status epilepticus, 1 (5.9%) generalized and 2 (11.8%) focal. recent adult case reports emphasize the importance of considering the differential diagnosis of complex partial status epilepticus in SLE patients presenting with confusion, acute behavioral changes or psychotic symptoms 37,38 . Myoclonic seizures were observed in one of our patients.…”

Estado epiléptico no convulsivo en el siglo XXI: clínica, diagnóstico, tratamiento y pronóstico

“…También se han visto involucradas drogas de abuso (cocaína, anfetaminas, heroína) [7]. Pacientes con enfermedades autoinmunes sistémicas con afectación del sistema nervioso central, como lupus eritematoso o púrpura trombótica trombocitopénica, han desarrollado cuadros estuporosos identificados como EENC [46,47].…”

Non-convulsive status epilepticus in adults - an overview

“…Furthermore, it may become especially difficult to diagnose dyscognitive SE in elderly patients in whom it is as frequent as of 40% [67][68][69]. Typical psychiatric manifestations of dyscognitive SE include delirium [67,70,71], stupor or catatonia [72,73], mental slowing [74], cognitive decline [75], aggressive behaviour [76] and psychotic depression [77].When spreading to the neocortical areas of the temporal lobes, auditory or visual hallucinations may occur [78,79]. The EEG of dyscognitive SE is characterised by irregular or regular focal spikes or spikewave activity similar to the one observed in aura continua; however, the ictal activity in dyscognitive SE tends to involve a larger area which increases the likelihood to detect it by surface EEG ( fig.…”