Abstract | RATIONALE: METHODS: Our patient was diagnosed with fragile X syndrome with a fully mutated, fully methylated FMR1 gene resulting in 572 CGG repeats. He developed seizures initially controlled with Depakote monotherapy, but progressed to become medically refractive to combination treatment with Depakote, lamotrigine and zonisamide. Prolonged video EEG monitoring revealed interictal left temporal sharp waves and slowing as well as subclinical and clinical seizures, each with left temporal onset. 3T MRI was consistent with left mesial temporal sclerosis. After discussing the case in our multidisciplinary surgical epilepsy conference, he was referred for presurgical evaluation including neuropsychological testing and Wada testing. RESULTS: He underwent an asleep left anterior temporal lobectomy, sparing the superior temporal gyrus. Pathology showed neuronal loss and gliosis in the hippocampus and amygdala. Twelve months after surgery, the patient has not experienced a seizure. He is described by his parents as less perseverative and less restless. CONCLUSIONS:
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Authors | Cynthia Kenmuir, Mark Richardson, Gena Ghearing |
Journal | Brain & development
(Brain Dev)
Vol. 37
Issue 9
Pg. 916-8
(Oct 2015)
ISSN: 1872-7131 [Electronic] Netherlands |
PMID | 25857623
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- FMR1 protein, human
- Fragile X Mental Retardation Protein
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Topics |
- Adult
- Drug Resistant Epilepsy
(complications, surgery)
- Epilepsies, Partial
(complications, surgery)
- Epilepsy, Temporal Lobe
(complications, surgery)
- Fragile X Mental Retardation Protein
(genetics)
- Fragile X Syndrome
(complications, genetics)
- Humans
- Male
- Mutation
- Young Adult
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