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Lookup NU author(s): Dr Yi NgORCiD, Dr Henriette van Ruiten, Dr Vankateswara Ramesh, Professor Robert Taylor, Emeritus Professor Doug Turnbull, Professor Grainne Gorman, Professor Bobby McFarlandORCiD, Professor Mark BakerORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2017 The Authors. Epilepsia Open published by Wiley Periodicals Inc. on behalf of International League Against Epilepsy. Focal status epilepticus in POLG-related mitochondrial disease is highly refractory to pharmacological agents, including general anesthesia. We report the challenges in managing a previously healthy teenager who presented with de novo epilepsia partialis continua and metabolic stroke resulting from the homozygous p.Ala467Thr POLG mutation, the most common pathogenic variant identified in the Caucasian population. We applied transcranial direct current stimulation (tDCS; 2 mA; 20 min) daily as an adjunctive therapy because her focal seizures failed to respond to five antiepileptic drugs at maximal doses. The electrical and clinical seizures stopped after 3 days of tDCS. The second course of tDCS was administered for 14 days when the focal seizures re-emerged a month later. The patient tolerated the procedure well. Following 4 months of hospitalization and prolonged community rehabilitation, our patient has now returned to full-time education with support, and there is no report of cognitive deficit. We have demonstrated the safety and efficacy of tDCS in treating refractory focal motor seizures caused by mitochondrial disease.
Author(s): Ng YS, van Ruiten H, Lai HM, Scott R, Ramesh V, Horridge K, Taylor RW, Turnbull DM, Gorman GS, McFarland R, Baker MR
Publication type: Article
Publication status: Published
Journal: Epilepsia Open
Year: 2018
Volume: 3
Issue: 1
Pages: 103-108
Print publication date: 01/03/2018
Online publication date: 06/12/2017
Acceptance date: 20/11/2017
Date deposited: 23/04/2019
ISSN (electronic): 2470-9239
Publisher: Wiley-Blackwell Publishing Ltd
URL: https://doi.org/10.1002/epi4.12094
DOI: 10.1002/epi4.12094
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