Evidence map›Paper›PMID 31230590›Full record

ArticleJournal of medical case reports2019

Epilepsia partialis continua complicated by disseminated tuberculosis and hemophagocytic lymphohistiocytosis: a case report.

Gashirai K Mbizvo, Isabel C Lentell, Clifford Leen, Huw Roddie, Christopher P Derry, Susan E Duncan, Kristiina Rannikmäe

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In one paragraph

Article in Journal of medical case reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Epilepsia partialis continua: A review.Neurosciences (Riyadh, Saudi Arabia) · 2024
    Review
  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Gashirai K MbizvoMuir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, 20 Sylvan Place, Edinburgh, EH9 1UW, UK. gashirai.mbizvo@ed.ac.uk.ORCID http://orcid.org/0000-0002-9588-2944
Isabel C LentellHaematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Clifford LeenRegional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK.
Huw RoddieDepartment of Haematology, Western General Hospital, Edinburgh, UK.
Christopher P DerryDepartment of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
Susan E DuncanMuir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, 20 Sylvan Place, Edinburgh, EH9 1UW, UK.
Kristiina RannikmäeForth Valley Royal Hospital, Larbert, and Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
Western General Hospital · GBCambridge University Hospitals NHS Foundation Trust · GBForth Valley Royal Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe describe a patient copresenting with epilepsia partialis continua, tuberculosis, and hemophagocytic lymphohistiocytosis. To our knowledge, this is the first documented case of this triad. CASE PRESENTATION: A 54-year-old black South African woman presented to a hospital in Scotland with an acute history of right-sided facial twitching, breathlessness, and several months of episodic night sweats. Clinical examination revealed pyrexia and continuous, stereotyped, right-sided facial contractions. These worsened with speech and continued through sleep. A clinical diagnosis of epilepsia partialis continua was made, and we provide a video of her seizures. Computed tomographic imaging of the chest and serous fluid analyses were consistent with a diagnosis of disseminated Mycobacterium tuberculosis. An additional diagnosis of hemophagocytic lymphohistiocytosis was made following the identification of pancytopenia and hyperferritinemia in peripheral blood, with hemophagocytosis evident in bone marrow investigation. We provide images of her hematopathology. The patient was extremely unwell and was hospitalized for 6 months, including two admissions to the intensive care unit for ventilatory support. She was treated successfully with high doses of antiepileptic drugs (benzodiazepines, levetiracetam, and phenytoin) and 12 months of oral antituberculosis therapy, and she underwent chemotherapy with 8 weeks of etoposide and dexamethasone for hemophagocytic lymphohistiocytosis, followed by 12 months of cyclosporine and prednisolone.

conclusionsThis combination of pathologies is unusual, and this case report helps educate clinicians on how such a patient may present and be managed. A lack of evidence surrounding the coexpression of this triad may represent absolute rarity, underdiagnosis, or incomplete case ascertainment due to early death caused by untreated tuberculosis or hemophagocytic lymphohistiocytosis. Further research is needed.

Indexed as

Epilepsia Partialis ContinuaFemaleHumansLymphohistiocytosis, HemophagocyticMiddle AgedTuberculosisAnticonvulsantsEpilepsia partialis continuaEpilepsyEtoposideHemophagocytic lymphohistiocytosisImmunosuppressionMacrophage activation syndromeSeizuresStatus epilepticusTuberculosis

Identifiers

PMID31230590
PMCPMC6589876
OpenAlexW2952917058

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.