Man Achieves Stable Recovery After 8 Days of Medication for Epileptic Seizure at Age 55
In this medical case study, we explore the successful treatment of a 55-year-old male who experienced epileptic seizures following a cold and fever. After receiving targeted medication for 8 days, the patient's symptoms were effectively controlled, and no further seizures occurred. The case highlights the importance of timely diagnosis and proper treatment in managing acute epilepsy episodes.
Patient Overview
Patient: Male, 55 years oldCondition: Epileptic seizureHospital: The Second Affiliated Hospital of Harbin Medical UniversityVisit Date: January 2022
Treatment Approach
Therapy: Oxygen therapy combined with a comprehensive medication regimen including Sodium Valproate for injection, Mannitol Injection, Xingnaojing Injection, Shuxuening Injection, Cefoperazone Sodium and Sulbactam Sodium for injection, and Oxcarbazepine Tablets.Duration: 8-day inpatient care with regular follow-up assessments.Outcome: Significant reduction in seizure symptoms and no recurrence post-treatment.
Initial Consultation
The patient, a 55-year-old man, developed episodic convulsions five days after catching a chill and experiencing a fever. Symptoms included loss of consciousness, arm flexion, leg extension, vocal outbursts, tongue biting, urinary incontinence, and upward eye rolling. He experienced three such episodes, each lasting approximately 2–3 minutes. After each seizure, he remained disoriented for about 10 minutes before gradually regaining full awareness, with no memory of the event. His body temperature reached as high as 38.7°C. The patient visited the hospital outpatient department, where a head CT scan revealed bilateral lacunar cerebral infarction. Hospitalization was recommended for further evaluation and management of the seizure episodes.
Medical Intervention
Upon admission, the patient was alert but had a temperature of 38.3°C, blood pressure of 150/100 mmHg, a heart rate of 97 bpm, and respiration rate of 16 breaths per minute. Eye movements were normal, muscle tone was within range, and neck stiffness was present. The treatment plan included oxygen administration and a series of diagnostic tests: blood culture, complete blood count, urinalysis, C-reactive protein, procalcitonin, cranial MRI, and EEG.
After discussing the case with the patient's family, it was determined that the three seizure episodes within six months were consistent with epilepsy. The family consented to antiepileptic therapy. Intravenous Sodium Valproate and oral Oxcarbazepine were administered to control seizures. Additional treatments included Mannitol for cerebral edema, Xingnaojing to protect brain tissue, Shuxuening to improve cerebral circulation, and Cefoperazone/Sulbactam for potential infection.
Diagnostic Results
Imaging and EEG findings supported the clinical diagnosis of seizure activity. The MRI showed changes consistent with previous small strokes, while the EEG revealed abnormal brain wave patterns indicative of epileptic tendencies.
Recovery and Discharge
Following eight days of intensive treatment, the patient showed marked improvement. The physical symptoms of seizure—arm flexion, leg extension, vocalizations, and eye movements—had ceased. His temperature returned to normal, and his vital signs stabilized. He was discharged with instructions to continue oral antiepileptic medication without interruption to prevent recurrence or status epilepticus. Both the patient and his family were cooperative and understood the importance of adherence to treatment.
Post-Treatment Care and Recommendations
While the patient's condition improved significantly, it is crucial to emphasize ongoing precautions. During future seizures, caregivers should ensure the patient's safety by removing nearby objects and avoiding physical restraint, which could lead to injury. The patient was advised to avoid high-risk activities such as driving, swimming, diving, and working at heights. Maintaining a balanced lifestyle with adequate rest, proper nutrition, and stress management is essential for long-term seizure prevention.
Clinical Insight
Epileptic seizures can manifest in various forms depending on the type of episode. This case illustrates a classic generalized tonic-clonic seizure. However, other seizure types—such as absence seizures, focal seizures, or secondary generalized seizures—may present with more subtle symptoms like staring spells, localized muscle twitching, or dizziness. Individuals with a history of epilepsy should remain vigilant and seek prompt medical attention if any unusual neurological symptoms occur to prevent potential complications.