An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel

Atushi Nishimura; Toshiaki Abe; Takao Harasawa; Hiroshi Oba

doi:doi:10.11648/j.ajpn.20180603.14

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An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel

Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba

Published in American Journal of Psychiatry and Neuroscience (Volume 6, Issue 3)

Received: 31 May 2018 Accepted: 6 August 2018 Published: 3 September 2018

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Abstract

The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.

Published in	American Journal of Psychiatry and Neuroscience (Volume 6, Issue 3)
DOI	10.11648/j.ajpn.20180603.14
Page(s)	72-77
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Juvenile Myoclonic Epilepsy, Cerebellar Hyperintensity Area, Sequel, Cerebellar Insults, Cerebellar Seizures, Lamotrigine Withdrawal Syndrome, Perampanel

References

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APA Style

Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba. (2018). An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. American Journal of Psychiatry and Neuroscience, 6(3), 72-77. https://doi.org/10.11648/j.ajpn.20180603.14

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ACS Style

Atushi Nishimura; Toshiaki Abe; Takao Harasawa; Hiroshi Oba. An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. Am. J. Psychiatry Neurosci. 2018, 6(3), 72-77. doi: 10.11648/j.ajpn.20180603.14

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AMA Style

Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba. An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. Am J Psychiatry Neurosci. 2018;6(3):72-77. doi: 10.11648/j.ajpn.20180603.14

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@article{10.11648/j.ajpn.20180603.14,
  author = {Atushi Nishimura and Toshiaki Abe and Takao Harasawa and Hiroshi Oba},
  title = {An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel},
  journal = {American Journal of Psychiatry and Neuroscience},
  volume = {6},
  number = {3},
  pages = {72-77},
  doi = {10.11648/j.ajpn.20180603.14},
  url = {https://doi.org/10.11648/j.ajpn.20180603.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20180603.14},
  abstract = {The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.},
 year = {2018}
}

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TY  - JOUR
T1  - An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel
AU  - Atushi Nishimura
AU  - Toshiaki Abe
AU  - Takao Harasawa
AU  - Hiroshi Oba
Y1  - 2018/09/03
PY  - 2018
N1  - https://doi.org/10.11648/j.ajpn.20180603.14
DO  - 10.11648/j.ajpn.20180603.14
T2  - American Journal of Psychiatry and Neuroscience
JF  - American Journal of Psychiatry and Neuroscience
JO  - American Journal of Psychiatry and Neuroscience
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EP  - 77
PB  - Science Publishing Group
SN  - 2330-426X
UR  - https://doi.org/10.11648/j.ajpn.20180603.14
AB  - The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.
VL  - 6
IS  - 3
ER  -

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Author Information

Atushi Nishimura

Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan
Toshiaki Abe

Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan
Takao Harasawa

Department of Pediatric Neurology, Ashikaganomori Ashikaga Hospital, Tochigi, Japan
Hiroshi Oba

Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan

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APA Style

Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba. (2018). An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. American Journal of Psychiatry and Neuroscience, 6(3), 72-77. https://doi.org/10.11648/j.ajpn.20180603.14

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ACS Style

Atushi Nishimura; Toshiaki Abe; Takao Harasawa; Hiroshi Oba. An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. Am. J. Psychiatry Neurosci. 2018, 6(3), 72-77. doi: 10.11648/j.ajpn.20180603.14

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AMA Style

Atushi Nishimura, Toshiaki Abe, Takao Harasawa, Hiroshi Oba. An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel. Am J Psychiatry Neurosci. 2018;6(3):72-77. doi: 10.11648/j.ajpn.20180603.14

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@article{10.11648/j.ajpn.20180603.14,
  author = {Atushi Nishimura and Toshiaki Abe and Takao Harasawa and Hiroshi Oba},
  title = {An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel},
  journal = {American Journal of Psychiatry and Neuroscience},
  volume = {6},
  number = {3},
  pages = {72-77},
  doi = {10.11648/j.ajpn.20180603.14},
  url = {https://doi.org/10.11648/j.ajpn.20180603.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20180603.14},
  abstract = {The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.},
 year = {2018}
}

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TY  - JOUR
T1  - An Autistic Female with Refractory Juvenile Myoclonic Epilepsy and Sequelae of Neonatal Cerebellar Insults, Effectively Treated with Perampanel
AU  - Atushi Nishimura
AU  - Toshiaki Abe
AU  - Takao Harasawa
AU  - Hiroshi Oba
Y1  - 2018/09/03
PY  - 2018
N1  - https://doi.org/10.11648/j.ajpn.20180603.14
DO  - 10.11648/j.ajpn.20180603.14
T2  - American Journal of Psychiatry and Neuroscience
JF  - American Journal of Psychiatry and Neuroscience
JO  - American Journal of Psychiatry and Neuroscience
SP  - 72
EP  - 77
PB  - Science Publishing Group
SN  - 2330-426X
UR  - https://doi.org/10.11648/j.ajpn.20180603.14
AB  - The patient was a 27-year-old mildly intellectually disabled woman with autistic spectrum disorder (ASD) and juvenile myoclonic epilepsy (JME). The patient’s condition had shown resistance to many antiepileptic drugs; however, perampanel (PER) was effective. The patient’s electroencephalogram (EEG) records were consistent with those of JME, and brain magnetic resonance imaging showed a normal cerebrum and limbic system but the characteristic sequelae of cerebellar insults, such as cerebellitis. The discontinuation of lamotrigine (LTG) induced suspected myoclonic atonic seizures (MAS) that were worsened by adding levetiracetam (LEV) but improved by the administration of rafinamide (RFN). The further administration of PER improved all symptoms and EEG findings of the patient within two weeks, and the patient has been seizure-free for more than two years. The present case report demonstrates that the sequelae of neonatal cerebellitis can cause JME, and the withdrawal of LTG induces myoclonic atonic seizures. PER can modify the pathogenic cerebellar focus of JME.
VL  - 6
IS  - 3
ER  -

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