Diagnosis of pyridoxine-dependent epilepsy in an adult presenting with recurrent status epilepticus.

Pyridoxine-dependent epilepsy (PDE) is a genetic metabolic disease caused by inborn errors affecting vitamin B6 metabolism, which typically presents with neonatal seizures resistant to antiepileptic drugs (AEDs). Treatment with pyridoxine terminates seizures and prevents neurological decline. We describe a case in which the diagnosis was established at the age of 22 years.

Reversible cerebellar oedema secondary to profound hypomagnesaemia.

Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES).

Epilepsy in sub-Saharan Africa.

Over 10 million people in Africa have epilepsy of which most have no access to appropriate treatment. Epilepsy in Africa is different- the incidence is higher, and the causes and cultural attitudes towards it differ. This article examines the epidemiology, causes and treatment of epilepsy in sub-Saharan Africa and looks at the challenges to improve access to treatment and potential solutions and the implications for neurologists in more developed countries.

Epilepsy, poverty and early under-nutrition in rural Ethiopia.

Purpose: The incidence of epilepsy in Ethiopia is high compared with industrialised countries, but in most cases the cause of epilepsy is unknown. Childhood malnutrition remains widespread. We performed a case-control study to determine whether epilepsy is associated with poverty and markers of early under-nutrition.

Headache and high ESR: A cautionary tale.

A 69-year-old woman with new persistent right temporal headache and high ESR was diagnosed with temporal arteritis in primary care. She was started on steroids, but developed a right 6th nerve palsy with continuing headache and raised inflammatory markers. Investigation revealed a sphenoid sinus abscess with intracranial extension and extensive cerebral venous sinus thrombosis.

The problem of epilepsy and its care in rural Ethiopia.

Background: Jimma University Hospital (JUH) in south west Ethiopia has been running an integrated rural chronic disease programme since 1999, focusing on treatment of epilepsy, diabetes and heart disease.

Objective: The purpose of this review is to compare clinical data of the epilepsy patients with those previously published from a similar programme in Gondar university, in the north west of the country.

Method: In November 2005, we identified a total of 1,250 patients with epilepsy from the JUH study with case records for analysis.

Three soccer playing friends with simultaneous amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis is a neurodegenerative disease of largely unknown cause, predominantly affecting upper and lower motor neurons. A recent study in Italy suggested an increased incidence of ALS among professional Italian soccer players. We report a cluster of three amateur league soccer players who were friends from the same part of southern England, and developed ALS simultaneously.

Unexpected amnesia: are there lessons to be learned from cases of amnesia following unilateral temporal lobe surgery?

Cases of amnesia following unilateral temporal lobe surgery are rare, but they may provide important insights into human brain functioning. Such cases are reconsidered here in the light of recent developments in clinical and cognitive neuroscience. Descriptions of preoperative seizure activity in these cases indicate the potentially valuable role of ictal semiology in localizing the source of epileptiform discharges.