Case of Adult Onset, Nocturnal, Refractory, Partial-Motor Epilepsy

This case report discusses the complex presentation and management of a 22-year-old female with medically refractory nocturnal focal epilepsy of unknown etiology.Initially misdiagnosed with a panic attack, the patient later exhibited tonic-clonic seizures and focal motor seizures predominantly during sleep, leading to a diagnosis of refractory epilepsy.Despite trials with multiple anti-epileptic drugs (AEDs), including Levetiracetam (Keppra), Lamotrigine (Lamictal), and Lacosamide (Vimpat), the patient continued to experience seizures, necessitating the placement of a responsive neurostimulation (RNS) device.This report highlights the challenges of diagnosing and managing epilepsy with an unclear etiology and emphasizes the potential benefits of surgical interventions in medically refractory cases.