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Epilepsy and phenylketonuria: a case description and EEG-fMRI findings.
[phenylketonuria]
Phenylketonuria
(
PKU
)
is
characterized
by
phenylalanine
accumulation
due
to
phenylalanine
hydroxylase
deficiency
.
Up
to
50
%
of
PKU
patients
experience
seizures
.
We
evaluated
an
adult
PKU
patient
who
suffered
from
absences
and
primarily
generalized
tonicclonic
seizures
,
associated
with
generalized
spikeand-wave
discharges
(
GSWs
)
on
EEG
.
An
analysis
of
blood
oxygenation
level-dependent
(
BOLD
)
signal
changes
during
interictal
epileptiform
discharges
showed
early
activation
of
the
left
perirolandic
cortex
followed
by
a
BOLD
signal
decrease
within
cortical
regions
belonging
to
the
default
mode
network
and
left
frontoparietal
cortex
.
Moreover
,
deactivation
of
the
head
of
the
right
caudate
nucleus
and
the
left
thalamus
was
observed
.
The
fMRI
pattern
observed
in
our
patient
during
GSWs
is
similar
but
not
identical
to
that
observed
in
idiopathic
generalized
epilepsy
,
suggesting
different
neurophysiological
mechanisms
.
This
is
the
first
description
of
BOLD-fMRI
patterns
in
a
PKU
patient
with
epilepsy
.
Similar
studies
in
more
patients
might
help
to
uncover
the
pathophysiology
of
seizures
in
this
disease
.
Diseases
Validation
Diseases presenting
"epilepsy"
symptom
22q11.2 deletion syndrome
adrenomyeloneuropathy
alexander disease
canavan disease
classical phenylketonuria
cohen syndrome
cowden syndrome
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
kabuki syndrome
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neonatal adrenoleukodystrophy
pendred syndrome
phenylketonuria
proteus syndrome
pyruvate dehydrogenase deficiency
sneddon syndrome
wolf-hirschhorn syndrome
zellweger syndrome
This symptom has already been validated