Dados do Trabalho

Título

Seizure control induced by tactile stimuli, not always a conversion disorder

RESUMO

Case Report
A 50 years old male, with previous medical history of systemic arterial hypertension and diabetes mellitus, presented a 20 days onset of paroxysmal abnormal movements at left side limbs, with 5 minutes duration, and ataxia in between episodes. At neurological evaluation, a complex movement disorder was observed, with predominantly hemiballism, but clonic-tonic paroxysmal seizures, with 2 minutes duration and EEG electric ictal activity, were observed. These seizures ceased clinically and electrographically with tactile stimulus. Excluding structural and other metabolic causes after normal brain MRI, CSF analysis and blood tests, chemical control of blood glucose with insulin showed improvement in clinical symptoms. Patient was discharged and in follow-up was asymptomatic.

Discussion:
Separately, seizures and hemiballism are an uncommon complication of non cetotic hyperglicemic states. In this case report, we showed a very rare complex movement disorder, with components of both clincal conditions. More importantly,although pathophisiologicaly explained in few studies, with cases in which seizure cessation was obteined by auditive stimulus, both clinically and eletrographically, with tactile stimulus have no case report ,being the presented above unique.


Final comments:
Although rare, hyperglycemia induced seizures and movement disorders must be in differential diagnosis, especially because they can be easily treated. Furthermore, more data about seizures inhibitor effects of sensorial stimulus are needed and possibly supports the development of new therapies.

Palavras Chave

chorea, hemibalism, seizure, sensory stimulation, hyperglycemia