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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
"cortical regions"
symptom
22q11.2 deletion syndrome
alexander disease
phenylketonuria
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