Partial seizures manifesting as apnea only in an adult

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.