Neurophysiology Case Histories - Case 4

A 52-year-old male complained of episodic experiences (1/day) of brief (1 or 2 minute) loss of contact with his surroundings, during which time he had a glassy stare, uttered unintelligible sounds and did not understand what was being said around him. Each episode was preceded by a sinking feeling in his stomach. His blood work indicated normal electrolytes and normal serum glucose. His EEG showed interictal bilateral temporal and left frontal lobe spikes appearing at about 3/second. Skull X-rays and CT scan were normal. The cause of these episodes was diagnosed as idiopathic. Drug therapy was begun with carbamazepine (Tegretol) at low doses, increasing over the week to the standard therapeutic dosage of 200 mg four times each day. Blood levels of 8µg/mL indicated that his effective therapeutic level had been reached, and the brief episodic experiences disappeared.

1. What is the disorder of this individual?

2. What are the major classifications of this disorder?

3. Define ictal/interictal.

4. Why were the skull X-ray and CT scan performed?

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