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A young woman with depression was referred for evaluation of refractory stereotypical seizures. These started 12 months before, manifesting as a brief feeling of panic and strange abdominal sensation (‘fluttering’), followed by an apparently minimally responsive ‘dreamy’ state lasting around 20 min.
The initial suspicion of temporal lobe epilepsy was strengthened by a subsequently requested sleep-deprived electroencephalography (EEG), reported elsewhere as showing ‘frequent runs of sharp activity over the temporal regions supporting a focal seizure disorder’. She subsequently tried three different antiepileptic medications (carbamazepine, then levetiracetam, then levetiracetam and sodium valproate) with no improvement and then increasingly frequent events. MR scan of brain was normal.
Ambulatory EEG captured several stereotypical clinical attacks during which the EEG remained normal. However, as she became drowsy during the recording, there were repeated runs of prominent …
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