Which conditions are included in the differential diagnoses of epilepsy partialis continua (EPC)?

Updated: Feb 13, 2018
  • Author: Julie L Roth, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Epilepsy partialis continua

For epilepsy partialis continua (EPC), with its associated semirhythmic, repetitive muscle twitching, the differential diagnosis is a bit different from that of SPSE and CPSE. Other entities to consider include nonepileptic myoclonus, such as those of basal ganglia, brainstem, or spinal origin. The coexistence of other overt complex partial and secondarily generalized seizures and epileptiform changes in the EEG help make this distinction.

A finding of bilateral or multifocal myoclonic process argues against focal epilepsy. Multifocal myoclonus is frequently encountered in very ill, hospitalized patients, often after systemic hypoxemia, though it is occasionally related to medications or metabolic derangements.

Other movement disorders (eg, choreiform disorders, hemiballismus, tic disorders, opsoclonus-myoclonus syndrome) might theoretically be mistaken for EPC. Careful evaluation of the movements, EEG, and accompanying history may assist in differentiation. Finally, a psychogenic process may emulate EPC in rare cases.


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