Refractory status epilepticus in an elderly patient with cerebral venous thrombosis and chronic ischemic stroke

Abstract

Cerebral venous thrombosis was one of the diseases thought to be uncommon before non-invasive neuroimaging techniques were introduced. Current statistics indicate that the annual incidence of cerebral venous thrombosis is 3-4 cases per million (1,2). The most frequent symptoms of CVT are epileptic seizures or even status epilepticus, that usually appear in the early stages of the disease (3,4). Recent studies show that the incidence of status epilepticus (SE) in the elderly has risen lately, causing lethal outcome in 38% of the patients, significantly more than in young adults (14%) (11). Cerebral venous thrombosis (CVT) is a major cause of SE, 25% developing seizures in the early stages of the disease as the first symptom of cerebral thrombosis (3,10). We present the case of an 86-year-old patient with de novo partial SE of the right limbs. The SE was generated by CVT with haemorrhagic transformation and chronic Sylvian stroke in a patient with multiple comorbidities.

Keywords

• cerebral venous thrombosis
• elderly
• status epilepticus