Purpose: Although several cases of apneic seizures have been reported in ne
onates, epileptic seizures presenting as apnea only in adults are very rare
. We present a case report of a 19-year-old man with viral encephalitis and
frequent episodes of apneic seizures.
Methods: Prolonged electroencephalograms (EEGs), repiratory monitorings, an
d imaging including ictal-interictal subtraction single photon emission com
puted tomography (SPECT) coregistered with magnetic resonance imaging (MRI)
were performed.
Results: Ictal EEGs recorded during apneic episodes showed repetitive sharp
waves or rhythmic theta activity arising from the left or right independen
t bitemporal region. Ictal SPECT was performed during one episode of apnea
that showed ictal EEG discharges arising from the left posterior temporal a
rea. Ictal-interictal subtraction SPECT coregistered with MRI revealed that
the seizures originated from the left,posterior, midlateral temporal corte
x.
Conclusions: Previous studies with ictal EEG or brain stimulation suggest t
hat apneic seizures might be mediated through the limbic and associated cor
tical systems. Our study reports on a very rare case of partial seizures wi
th apnea only in an adult patient and is supported by ictal EEG and ictal-i
nterictal subtraction SPECT coregistered with MRI.