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Induction of seizures due to cortical hyperexcitability during a podiatric physical examination in an epileptic patient: A case report
Patel, Priyal Kaur, Kushkaran Hussain, Nausheen
Patel, Priyal
Kaur, Kushkaran
Hussain, Nausheen
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Journal article
Date
2022-07-01
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Podiatric Medicine
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http://dx.doi.org/10.55067/jifaf.v1i7.22
Abstract
Epilepsy is a neurological disorder affecting the central nervous system and is characterized by recurrent and unprovoked seizures. Seizures often occur due to cortical hyperexcitability because of inappropriate sensory, cognitive, and reflex stimuli. Epilepsy has numerous etiologies, each related to an underlying central nervous system dysfunction. Focal seizures are limited to a single cerebral hemisphere, whereas general seizures involve both hemispheres. Literature review has shown the use of transcranial magnetic stimulation for inciting epileptic seizures, as well as the use of a tuning fork to elicit non-epileptic seizures (NES). However, minimal research exists demonstrating the use of a 128-Hz tuning fork to induce epileptic seizures. Clinical symptoms of psychogenic non-epileptic seizures (PNES) and epileptic seizures are very similar to the untrained eye and without the assistance of an EEG, one cannot distinguish the two. We report a case in which a 71-year-old female experienced symptoms consistent with an “aura” or onset of a seizure when subjected to an examination of vibratory sensation to the left medial malleolus during a general podiatric examination. The patient’s past medical history includes partial symptomatic epilepsy with complex partial seizures in addition to NES. The authors agree that it is imperative to practice with caution when conducting a general podiatric examination on a patient who is predisposed to epileptic activity, as the threshold for an induction of a seizure may be lowered.
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Citation
Khan K, Patel P, Kaur K, Hussain N. Induction of seizures due to cortical hyperexcitability during a podiatric physical examination in an epileptic patient: A case report. J Int Foot Ankle [Internet]. 2022 Jul. 1 [cited 2024 Apr. 16];1(7). Available from: https://internationalfootankle.org/journal/index.php/JIFAF/article/view/22
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International Foot & Ankle Foundation
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Journal of the International Foot & Ankle Foundation, Vol. 1, No. 7
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