Sustained Effect of Botulinum Neurotoxin in Myoclonus Owing to Epilepsia Partialis Continua

Abstract

Background: Epilepsia partialis continua (EPC) is defined as continuous myoclonic jerking of a body part of cortical origin and often resembles a movement disorder. Unfortunately, anti-epileptic therapy is frequently ineffective. Currently, the effect of botulinum neurotoxin (BoNT) therapy in EPC is controversial.

Successful treatment of epilepsia partialis continua with perampanel: two pediatric cases

“…To our knowledge, there are as yet only two reports in the literature demonstrating successful treatment of EPC with perampanel in adult patients (table 2). [6,7,11] Focal resection Focal cortical dysplasia [12] Sturge-Weber syndrome [40] Subpial dissection Rasmussen encephalitis [40] Neurostimulation Chronic cortical stimulation Unknown Old ischemic insult [19] rTMS Non-specific [20] tDCS POLG-related mitochondrial disease Autoimmune epilepsy [21] [41] Vagus nerve stimulation Rasmussen encephalitis Chronic inflammatory encephalitis [18] AEDs Perampanel Meningioma [42] Rasmussen encephalitis [43] Levetiracetam Oligodendroglioma [22] ICH [23] Non-specific [10] Topiramate Non-specific [24] Lacosamide Subdural hematoma [25] Primidone Unknown [26] Immunotherapy Immunomodulatory treatments Rasmussen encephalitis [13] Others Botulinum toxin Rasmussen encephalitis [14] Anaplastic astrocytoma [16] Metabolic correction Non-ketotic hyperglycemia [15] [17] AEDs: antiepileptic drugs; ICH: intracerebral hemorrhage; rTMS: transcranial magnetic stimulation; tDCS: transcranial direct current stimulation. In this article, we report the successful treatment of EPC in two pediatric patients, one with NCL and the other with POLG-related mitochondrial disease.…”

“…Etiology-specific treatments, such as hemispherotomy for Rasmussen encephalitis, lesionectomy for FCD, and metabolic correction for non-ketotic hyperglycemia, have proven to be efficacious in treating EPC [6,8,11,12]. Various other therapies have been reported to successfully stop EPC, but there are too few cases to reach any definite conclusions [13][14][15][16][17] (table 1). Neurostimulation techniques, such as vagus nerve stimulation [18,19], transcranial magnetic stimulation [20] (Rotenberg et al, 2009) and transcranial direct current stimulation [21], have also been used to successfully treat EPC.…”

“…Vagus nerve stimulation Rasmussen encephalitis Chronic inflammatory encephalitis [18] AEDs Perampanel Meningioma [42] Rasmussen encephalitis [43] Levetiracetam Oligodendroglioma [22] ICH [23] Non-specific [10] Topiramate Non-specific [24] Lacosamide Subdural hematoma [25] Primidone Unknown [26] Immunotherapy Immunomodulatory treatments Rasmussen encephalitis [13] Others Botulinum toxin Rasmussen encephalitis [14] Anaplastic astrocytoma [16] Metabolic correction Non-ketotic hyperglycemia [15] [17] AEDs: antiepileptic drugs; ICH: intracerebral hemorrhage; rTMS: transcranial magnetic stimulation; tDCS: transcranial direct current stimulation.…”