Diagnostic and Management Complexities in Epilepsia Partialis Continua: A Case Series

Epilepsia Partialis Continua (EPC) is a variant of focal motor status epilepticus wherein frequent repetitive, usually rhythmic muscle jerks continue over prolonged periods of time. EPC can occur because of any space-occupying lesion, vascular aetiology, mitochondrial disease, and Rasmussen encephalitis. There is a paucity of evidence regarding the prevalence; however, regional studies have suggested a prevalence of one per million population. This case series presents three cases wherein the aetiology has been known to have a highly rare correlation with the clinical presentation of EPC. Index case one, already a known case of generalised epilepsy, presented with clinical features suggestive of acute viral hepatitis, later found to be hepatitis A positive, had EPC that lasted around four days. In index case two, the child presented with features suggesting focal status epilepticus, which also persisted despite use of multiple anti-epileptic agents, and was later found to be positive for parvovirus antibodies in serum as well as Cerebrospinal Fluid (CSF). In index case three, the child presented with focal seizures, which on imaging had structural changes and an abnormal Electroencephalography (EEG). These children were given multiple antiepileptic agents; however, the repetitive movement subsided on its own and all of them were discharged on haemodynamically stable conditions. The present case series highlights the clinical heterogeneity of the disease process, as well as the challenges and complexities involved in diagnosis and management.