An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel
American Journal of Psychiatry and Neuroscience
Volume 6, Issue 3, September 2018, Pages: 72-77
Received: May 31, 2018; Accepted: Aug. 6, 2018; Published: Sep. 3, 2018
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Atushi Nishimura, Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan; Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan
Toshiaki Abe, Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan; Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
Takao Harasawa, Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan
Hiroshi Oba, Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
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The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.
Juvenile Myoclonic Epilepsy, Cerebellar Hyperintensity Area, Sequel, Cerebellar Insults, Cerebellar Seizures, Lamotrigine Withdrawal Syndrome, Perampanel
To cite this article
Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba, An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel, American Journal of Psychiatry and Neuroscience. Vol. 6, No. 3, 2018, pp. 72-77. doi: 10.11648/j.ajpn.20180603.14
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