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    "Forced Behavior" as epileptic seizure: Description of a patient with neuronal migration disorder

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    Forced thinking and behavior can be true epileptic phenomena. Forced thinking, characterized by abrupt intrusion of thoughts, could be produced by an epileptic discharge in frontal or temporal lobes Epileptic forced thinking appears distinct from obsessive thoughts and compulsive urges. A male patient, teacher of optic pathophysiology, from the age of 40 showed short (2-3 minutes) episodes, characterized by a compulsive urge to speak technically as he would in his job. At the age of 43 he showed two nocturnal generalized seizures. An EEG was performed and it showed intercritical and critical anomalies on the left anterior regions. A magnetic resonance (MR) showed the presence of a neuronal migration disorder (sub-ependimal cotrical nodular heterotopia). Soon after, a therapy with carbamazepine 800 mg/die was started and all types of paroxystical manifestations disappeared. This case is interesting and intriguing because of the overlapping of epilepsy, forced behavior and neuronal migration disorders. Considering the anatomic systems involved in epilepsy and obsessive-compulsive disorder, we will discuss the differences and the common features of both disturbances

    Effetti sul sonno notturno e sulla sonnolenza diurna del trattamento cronico con Lamotrigina

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    Lamotrigine (LTG) is a new antiepileptic drug, currently used in medically intractable patients. We studied nocturnal sleep and daytime somnolence in 13 patients undergoing add-on therapy with LTG for seizures resistant to common antiepileptic drugs (AEDs). LTG caused a significant increase of REM sleep and a significant decrease of SWS, of the number of stage shifts and of the number of entries in REM. No significant changes were observed in daytime sleepiness and cognitive functions after 3 months of treatment. The increased stability of nocturnal sleep could play an important role in the anticonvulsant effect of LTG
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