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A young man with bilateral epilepsia intractable and partialis continua

¹ SpR in Neurology, Department of Neurology, Western General Hospital, Edinburgh, UK
² Professor in Clinical Neurology, Queen Square, London, UK
³ Consultant Neuropathologist, Western General Hospital, Edinburgh, UK
⁴ Reader in Neurology, Ninewells Hospital, Dundee, UK
⁵ Professor of Medical Neurology, Western General Hospital, Edinburgh, UK

Correspondence to:
Correspondence to:
Dr K Murray, Department of Neurology, Western General Hospital, Edinburgh EH4 2XY, UK;
Kmurray12@doctors.org.uk

The first 150 words of the full text of this article appear below.

THE INITIAL STORY

A young man in his late teens presented with a four week history of malaise, vomiting, anorexia, and 7 kg weight loss. He was dehydrated and barium follow through revealed a band like obstruction of the 3rd and 4th parts of the duodenum. Following rehydration and normalisation of his biochemistry he had three generalised tonic-clonic seizures and was started on sodium valproate. This failed to control his seizures and phenytoin was added. He also experienced visual hallucinations, for instance seeing toilet seats being swallowed up. Laparotomy confirmed duodenal obstruction secondary to Wilkie’s syndrome (obstruction between the angle of the aorta and superior mesenteric artery, seen in association with weight loss). A duodeno-jejunal anastamosis was performed.

Postoperatively his neurological condition deteriorated with increasing confusion, headache, and left sided myoclonus and weakness so he was transferred to the neurology service. The past medical history was revisited. He had had a normal birth . . . [Full text of this article]