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Case 31 

Case 31
Chapter:
Case 31
Author(s):

Sarah T Pendlebury

, Philip Anslow

, and Peter M Rothwell

DOI:
10.1093/med/9780192631626.003.0031
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date: 21 September 2018

A 33-year-old female librarian was brought by her husband to the emergency department with odd behaviour. She had been well until 2 days previously but since that time had been wandering about the house in an apparently confused state, staring blankly, and not replying to her husband’s questions. There was a past medical history of epilepsy beginning during eclampsia associated with her second pregnancy 6 years earlier. Her seizures were usually generalized motor seizures but sometimes she would become vague or experience déjà vu. Her epilepsy had been difficult to control initially but over the 6 months prior to the time of presentation in the emergency department, she had had about 1 seizure a month. She had developed mild memory and more general cognitive impairment since the onset of her epilepsy. Her antiepileptic medication comprised sodium valproate and lamotrigine, which had remained unchanged for over a year. Fluoxetine had recently been prescribed by her GP for depression.

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