%0 Journal Article
%T Pilomotor seizures marked by infraslow activity and acetazolamide responsiveness
%A Catherine Maurice
%A Luis Garcia Dominguez
%A Peter L. Carlen
%J Archive of "Annals of Clinical and Translational Neurology".
%D 2019
%R 10.1002/acn3.695
%X A patient with pilomotor seizures post anti©\LGI1 limbic encephalitis, refractory to immunotherapy and anti©\epileptic drugs, was investigated with electroencephalography and magnetoencephalography. Seizures occurred daily (14.9 ”Ą 4.9/day), with catamenial exacerbation, inducible by hyperventilation. Anterior temporal ictal onsets were heralded (by ~15 sec) by high amplitude ipsilateral electromagnetic infraslow activity. The catamenial/ventilatory sensitivity and the infraslow activity (reflecting glial depolarization) suggested an ionic, CO 2/pH©\related glioneuronal mechanism. Furosemide decreased seizure frequency by ~33%. Acetazolamide led to immediate seizure freedom, but lost efficacy with daily treatment. A cycling acetazolamide regimen (2 days on, 4 days off) plus low©\dose topiramate maintained >95% reduction (0.5 ”Ą 0.9/day) in seizures
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331207/