Faculty Bibliography

Bupropion is a well known atypical antidepressant marketed in the United States under the trade name Wellbutrin. In its sustained release form, it is also used for smoking cessation. It lowers seizure threshold and its potential to cause seizures has been widely publicized. Lamotrigine is a broad spectrum anticonvulsant with an extremely favorable side-effect profile and has thus rapidly become the preferred drug for a broad range of seizure types such as absence seizures, primary generalized epilepsy syndromes such as idiopathic generalized tonic-clonic seizures, juvenile myoclonic epilepsy as well as partial (focal) epilepsy. It is also used by psychiatrists as a mood stabilizer. We report a patient who presented with delayed status epilepticus following a failed suicidal attempt after overdosing on bupropion XL and lamotrigine

Patients at times present with neurological symptoms and signs for which at times extensive investigation fails to identify any structural or organic pathology within the nervous system. These pseudo neurological syndromes can mimic almost any organic disease of the central and peripheral nervous system. Some such as pseudo seizures also referred to as psychogenic non-epileptic seizures (PNES) are more commonly encountered than others. Pseudo neurological syndromes presenting as mononeuropathies have been documented in the neurological literature. We document here a patient presenting with wrist drop suggestive of radial nerve palsy and illustrate a simple clinical test which can help differentiate between true and false (pseudo) radial nerve palsy

Oro-alimentary automatisms such as chewing movements, lip-smacking, repeated snuffling, swallowing and retching have been reported with seizures usually of temporal lobe origin. Throat clearing, usually along with other vegetative signs, has been reported in patients with temporal and rarely extra-temporal lobe epilepsy. We report a case of a 93-year-old woman admitted with acute right temporo-occipital stroke. Repeated throat clearing episodes raised suspicion for complex partial seizures. Video-EEG recording confirmed frequent right hemispheric focal seizures originating from the right posterior temporal area concordant with her cortical stroke. The value of throat clearing as a sign of complex partial seizures of temporal lobe origin and its lateralizing and localizing value is discussed

When venous access is needed for intravenous fluids or antibiotics and a peripheral site is unavailable or not suitable, a central line is placed either in the neck or the groin. Complications have been reported during central line placement including (but not limited to) pneumothorax, haemothorax, arrhythmias, air embolism and introduction of infection. The case history is reported of a patient who developed ipsilateral hemispheric ischaemic hypoxic changes during central line placement. This was represented on the surface electroencephalogram by ipsilateral hemispheric voltage attenuation.