Ethosuximide in a case of epileptic negative myoclonus

S. Meregalli, P. M. Giambelli, G. Rubboli, C. A. Defanti

Research output: Contribution to journalArticlepeer-review

Abstract

Epileptic negative myoclonus (ENM) is an interruption of tonic muscular activity, time-locked to a spike or a sharp wave on the EEC, without evidence of antecedent myoclonia. This is a non-specific motor disorder that can depend on a dysfunction at different anatomo-functional levels. ENM occurs in patients suffering from different types of epileptic pathologies, whose etiology can be idiopathic, cryptogenic or symptomatic. Recently the literature has shown the efficacy of ethosuximide (ESM) in the treatment of ENM. We describe the case of a 9-year-old girl affected by cryptogenic (NMR negative) partial epilepsy, with clonic attacks involving the left inferior limb, apparently pharmacoresistant (she was treated with CBZ, VPA, VPA + BDZ, with attacks quite everyday). EEC showed abundant epileptiform activity, with spike, spike and wave and polyspike and wave involving the right fronto-central area; sleep activated this activity, with nearly continuous sharp-slow wave complexes in the same area and controlateral diffusion. After one year from the onset of epilepsy, frequent falls and fecal incontinence appeared; the EEC in polygraphy demonstrated the ENM phenomenon at the left inferior limb. The introduction of ESM dramatically resolved the attacks and the fecal incontinence. The incidence of ENM is probably underestimated and a diagnosis is possible only with EEG in polygraphy. We confirm the efficacy of ESM and we suppose a critical etiology of fecal incontinence.

Original languageEnglish
Pages (from-to)360
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume20
Issue number5
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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