Abstract
We reported a case, a 10 years old girl, with ESES with infarction of the right thalamus confirmed by CT scan and MRI. She began to have nocturnal hemiconvulsion at the age of 4 years 11 months old and atypical absence and unconscious adversive seizures at the age of 5 years and 7 months old. Overnight EEG recording at the age of 5 years and 11 months revealed that diffuse bilateral synchronous 2-2.5 Hz sharp and slow wave complexes with right hemispheric dominancy continued throughout the period of non-REM sleep without any discernible background activity (sp. w index=95%).
Her seizures gradually became more frequent and abnormal behaviors, the disturbance of short term memory and geographic orientation apeared. Institution of MCT ketogenic diet therapy successfully controlled the above troubles, but the improvement to the ESES was only transient for the period of observation of 4 years and 9 months.
We suggested that a loss of thalamic function may contribute to the genesis of such a rare epileptic condition as ESES and the continuous spike and wave complexes could cause the selective impairment of the higher cortical functions.
