Ictal Priapism as an Autonomic Manifestation of Panayiotopoulos Syndrome

Brabec, Jiri; Chaudhary, Shuchi; Ng, Yu-Tze
December 2013
Journal of Child Neurology;Dec2013, Vol. 28 Issue 12, p1686
Academic Journal
Case Study
Panayiotopoulos syndrome is an idiopathic epilepsy syndrome presenting with a large variety of autonomic symptoms. The mechanism of autonomic symptoms is still not well understood. A neurologically normal 13-month-old boy presented on 2 occasions with complex partial status epilepticus that included significant ictal priapism. Inpatient brain magnetic resonance imaging (MRI) scan showed restricted diffusion-weighted imaging within his left temporal lobe and electroencephalograms (EEGs) left temporal slowing only. An outpatient EEG 6 months later showed abundant multifocal, predominantly posterior, as well as irregular generalized spike-and-slow-wave discharges on normal background consistent with the diagnosis of Panayiotopoulos syndrome. Ictal priapism is a previously undescribed phenomenon that is consistent with parasympathetic manifestations noted in this young boy. Acute postictal MRI and EEG findings suggest that this undeniably fascinating seizure semiological sign may be localized to the left temporal region.


Related Articles

  • Clinical Characteristics and Prognostic Factors of Postencephalitic Epilepsy in Children. Yung-Jung Chen; Peng-Cheng Fang; Julie Chiu Chow // Journal of Child Neurology;Dec2006, Vol. 21 Issue 12, p1047 

    The goal of this study was to clarify the clinical characteristics and prognostic factors of childhood postencephalitic epilepsy. Forty-four patients (20 boys and 24 girls; age range 21 months to 17 years, mean age 8.1 ± 4.6 years) with postencephalitic epilepsy were selected from the 798...

  • Hemiconvulsion-Hemiplegia Syndrome and Elevated Interleukin-6: Case Report. Kimura, Masahiko; Tasaka, Masaru; Sejima, Hitoshi; Takusa, Yuichi; Ichiyama, Takashi; Yamaguchi, Seiji // Journal of Child Neurology;Sep2002, Vol. 17 Issue 9, p705 

    We report a 2-year-old boy who developed hemiconvulsion-hemiplegia syndrome with left-sided hemiplegia after a seizure lasting 35 minutes. The interleukin-6 level in the cerebrospinal fluid 2 hours after seizure onset was elevated to levels seen in patients with encephalitis. At 1 year after...

  • Effects of intra-accumbens injection of 2-methylthio ATP: a combined open field and electroencephalographic study in rats. Kittner, Holger; Krügel, Ute; Hoffmann, Eike; Illes, Peter // Psychopharmacology;2000, Vol. 150 Issue 2, p123 

    Abstract Rationale: Previous experiments have shown that P2 receptor activation increases the release of dopamine in the mesolimbic mesocortical system. Objective: In order to investigate the functional correlates of dopaminergic stimulation, EEG and behavioural responses to injection of the P2...

  • Pitfalls in Measuring Cerebrospinal Fluid Glycine Levels in Infants With Encephalopathy. Aburahma, Samah; Khassawneh, Mohammad; Griebel, May; Sharp, Gregory; Gibson, James // Journal of Child Neurology;Jun2011, Vol. 26 Issue 6, p703 

    In encephalopathic infants, cerebrospinal fluid hyperglycinemia and elevated cerebrospinal fluid to plasma glycine ratio are considered pathognomonic of nonketotic hyperglycinemia. To evaluate the significance of cerebrospinal fluid hyperglycinemia and elevated cerebrospinal fluid to plasma...

  • High Prevalence of Cysticercosis in People with Epilepsy in Southern Rwanda. Rottbeck, Ruth; Nshimiyimana, Jules Fidèle; Tugirimana, Pierrot; Düll, Uta E.; Sattler, Janko; Hategekimana, Jean-Claudien; Hitayezu, Janvier; Bruckmaier, Irmengard; Borchert, Matthias; Gahutu, Jean Bosco; Dieckmann, Sebastian; Harms, Gundel; Mockenhaupt, Frank P.; Ignatius, Ralf // PLoS Neglected Tropical Diseases;Nov2013, Vol. 7 Issue 11, p1 

    Background: Neurocysticercosis (NCC), the central nervous system infection by Taenia solium larvae, is a preventable and treatable cause of epilepsy. In Sub-Saharan Africa, the role of NCC in epilepsy differs geographically and, overall, is poorly defined. We aimed at contributing specific,...

  • CNS Infections: An Indication for Continuous EEG Monitoring? Kandula, Padmaja // Neurology Alert;Mar2009, Vol. 27 Issue 7, p53 

    ACUTE SYMPTOMATIC SEIZURES ARE A KNOWN COMPLICATION of central nervous system (CNS) infections. Traditionally, however, meningitides have been considered a medical and not neurological condition until focal neurologic signs or clinical seizures complicate the picture. In addition, use of...

  • Images in Neurology: Periodic Sharp Wave Complexes in patient with Creutzfeldt- Jakob Disease. Sethi, N. K.; Sethi, P. K.; Torgovnick, J. // Internet Journal of Neurology;2007, Vol. 7 Issue 1, p12 

    The article focuses complications in patient who is suffering from creutzfeldt-Jakob disease. Creutzfeldt- Jakob disease (CJD) is included under the umbrella of prior related neurodegenerative diseases. Sporadic CJD presents with rapidly progressive dementia and myoclonus. Diagnosis is typically...

  • 11C-Methionine positron emission tomography may monitor the activity of encephalitis. Hirata, Kenji; Shiga, Tohru; Fujima, Noriyuki; Manabe, Osamu; Usui, Reiko; Kuge, Yuji; Tamaki, Nagara // Acta Radiologica;Dec2012, Vol. 53 Issue 10, p1155 

    Encephalitis is generally diagnosed by clinical symptoms, cerebrospinal fluid examination, and imaging studies including CT, magnetic resonance imaging (MRI), and perfusion single photon emission tomography (SPECT). However, the role of positron emission tomography (PET) in diagnosis of...

  • Tilt the head to pick up brainwaves. Hamzelou, Jessica // New Scientist;12/3/2011, Vol. 212 Issue 2841, p14 

    The article discusses research by scientist Justin Rice and team on the accuracy of electroencephalography (EEG), exploring the role of cerebrospinal fluid (CSF) in the transmission of brain activity. Researchers conducted EEGs on subjects lying on their backs, fronts, and while sitting to study...


Read the Article


Sign out of this library

Other Topics