PMC8217744_01
Onset of infantile spasms at the age of 10 months. She was treated with NZP and VGB without benefit. IM ACTH treatment and successively, CLB in monotherapy provided a seizure-free period. At the age of 2 years, the patient showed focal seizures/focal to bilateral tonic-clonic seizures that failed several AED's treatment. Due to the high frequency of the seizures (>4 attacks/day) and frequency episodes of epileptic the child has been monthly hospitalized. Until now, LEV and cycles of ACTH provided the more significant benefits. VGB, Vigabatrin; NZP, Nitrazepam; ACTH, adrenocorticotropic hormone; CLB, Clobazam; VPA, Sodium Valproate Acid; LTG, Lamotrigine; TPM, Topiramate; LEV, Levetiracetam; CLZ, Clonazepam; RFN, Rufinamide; ETS, Etosuccimide; PB, Phenobarbital; OXC, Oxcarbazepine; PGB, Pregabalin; LCM, Lacosamide; PER: Perampanel; CBZ, Carbamazepine. +: Good therapeutic efficacy (decreasing frequency and/or intensity of seizures). -: Bad therapeutic efficacy (increasing and/or worsening of seizure frequency or severity). In red: excellent therapeutic efficacy (marked decrease in frequency and/or intensity of seizures).
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F1
Multiple-label and off-label antiepileptic drugs (AEDs) were prescribed without clinical effects (Figure 1).
Interictal electroencephalogram during sleep showing quasi-continuous, centro-temporal, and high voltage spike-and-wave complexes, frequently followed by theta-delta activity.
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F2
Interictal electroencephalogram (EEG) showed quasi-continuous spike-and-wave complex in the frontocentral region (Figure 2).
Electroencephalogram (EEG) during sleep after 3 months of CBD treatment. The recording showed a significant reduction of EEG abnormalities in frequency and amplitude, and the presence of sleep figures, including sleep spindles.
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F3
A new EEG was performed revealing an improvement in cerebral activity and a mild reduction of EEG abnormalities in comparison with her previous EEG (Figure 3).