F77. Etiological spectrum of epilepsia partialis continua

Abstract

Introduction Epilepsia Partialis Continua (EPC) is typically associated with structural lesions but has been described as a presenting feature of autoimmune and viral encephalitis. The relative proportion of patients with each etiology has not been well characterized. Methods A retrospective, single center analysis was performed based on a query of the EEG database from 1/2012 through 12/2017 (n = 50). The clinical presentation, etiology, presence of a culprit MRI lesion, and EEG findings was recorded. Results 50 patients were identified, 25 were female. Mean age: A structural lesion was seen in 46: neoplastic etiology was present in 13, hemorrhagic stroke in 12, ischemic stroke in 12, posttraumatic epilepsy in 2, autoimmune encephalitis in 2, metabolic in 1, demyelinating in 1, CNS vasculitis in 1. Only 5 patients had no corresponding MRI lesion; two of these had autoimmune encephalitis, 1 had giant cell arteritis, 1 had bacterial meningitis, and 1 was cryptogenic. In three of the five, an ictal pattern was seen on EEG. The two patients without EEG correlate, were noted to have hand clonic and face myoclonic movements respectively. Conclusion EPC in this dataset is mostly associated with neoplastic and vascular etiologies. Autoimmune encephalitis can present without imaging correlate and likely represents one of the most common diagnosis in cryptogenic EPC.