P-EP027. Elderly stroke presenting as epilepsia partialis continua

Abstract

Introduction. Stroke is one of the most common neurological event in elderly age group. Stroke usually leads to neurological deficits like weakness, paresthesia, speech defect, altered sensorium, etc. Seizures per se are a less common clinical manifestation of stroke, especially ischaemic stroke. Epilepsia partialis continua is an uncommon variety of epilepsy and is far less common in strokes. Results. This 70-year-old man, known hypertensive for last 20 years, presented with sudden onset abnormal involuntary movement of left upper limb. His vitals showed a blood pressure of 200/130 mmHg and pulse rate of 75/min, regular. Neurological evaluation revealed epilepsia partialis continua involving left upper limb without any other neurological deficit. He was thoroughly investigated and his brain MRI scan revealed infarct. He was treated with aspirin, atorvastatin, oxcarbazepine, lacosamide, clobazam and levetiracetam. He improved drastically on this medication and was discharged. He is doing well on follow-up. Conclusion. New onset epilepsia partialis continua in elderly should be considered for vascular origin. Diseases of vascular aetiology can have favourable prognosis than congenital or degenerative lesions especially in epilepsies.