Title : Epileptic Partialis Continua (Epc) as could be an initial presentation of HIV - A case report
Abstract:
21 yr male presented with no co morbidities presented with witnessed seizure(seminology characterized by jerky movements of left angle of mouth and left upper limb with up rolling eyeball and tongue bite followed by post ictal confusion).Managed conservatively by antiepileptic, a day later he developed repetitive involuntary clonic-myoclonic movement of left arm with facial deviation to right ,no loss of consciousness. He was then managed by sequential antiepileptics showing no significant reduction in seizure.
Examination
BMI 24.22Kg/m², General condition – Fair & stable,E4V4M6,Hypotonic and scanning dysarthria ,B/L Facial nerve palsy(Lt >Rt),EPCs present in Left upper (UL) & lower limbs(LL),Power – UL (Rt & Lt)- 4/5, LL (Rt & Lt)- 3/5,DTR – Lt Biceps and knee 3+ others 2+, B/L Plantar Extensor response +Lt cerebellar signs – Finger Nose test dysmeria + ,Heel chin dysmetria +,titubations noted
Management:
- He was diagnosed as a case of HIV Encephalopathy – EPC
- Managed with TLE regime (ART) and appropriate prophylaxis for opportunistic infections
- EPC controlled with 04 anti epileptics (Oxcarbazepine,Levitracetam,Lacosamide and Perampanel
- His HIV viral load reduced , CD4 levels increased to 278 cells/c.mm
- No EPC recurrence
