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Erle C H Lim

Publications and source records attributed to Erle C H Lim.

26 records · Page 2Linked to original sources
PubMed2005

Frequency of provocative factors in epileptic patients admitted for seizures: a prospective study in Singapore.

Intractable epilepsy is commonly believed to be the main cause of uncontrolled seizures and hospitalization in epileptic patients. We study frequency and types of potential provocative factors in epileptic patients admitted with seizures, and suggest methods to decrease seizure occurrence and hospitalization. Over 6 months we prospectively studied all epileptic patients hospitalized for seizures. A structured interview and laboratory investigations were used to determine type and number of potential seizure precipitants. Precipitants thought to be avoidable through actions taken by the patient or physicians were termed potentially preventable provocative factors (PPPF). Patients' awareness and knowledge of seizure precipitants were also assessed. Three quarters of all seizures leading to admission were associated with PPPF, the commonest being non-compliance (71%), sub-therapeutic doses of antiepileptic drugs (26%) and sleep deprivation (9%). Only one patient had intractable epilepsy. Patients' knowledge of seizure precipitants was poor. The majority of hospital admissions for seizures in epileptic patients are associated with potentially preventable causes amenable to education programmes. Patient education involving epilepsy nurse educators may play an important role in decreasing seizure occurrence and possibly unnecessary hospital admissions.

Adult↗
PubMed2005

Symptomatic segmental dystonia from a cavernous angioma in the centrum semiovale.

We describe a 68 year-old Chinese man who presented with segmental dystonia involving the neck and right upper limb, which was exacerbated with action. EEG and MRI of the cervical spine were unremarkable, but MRI of the brain revealed a small cavernous angioma measuring one centimeter in diameter in the left centrum semiovale. The dystonia was ameliorated but not abolished with trihexyphenidyl. Arteriovenous malformations have been described to cause movement disorders, but dystonia has not previously been reported in association with cavernous angiomas. A search of the literature revealed one report of a patient with chorea arising from a cavernous angioma. This interesting case illustrates how an uncomplicated cavernous angioma can rarely cause segmental dystonia and highlights the importance of neuroimaging in patients with late-onset movement disorders.

Aged↗
PubMed2005

Close temporal association of bronchial asthma and ischemic colitis--case report and review of the literature.

We report a case of ischemic colitis in an elderly male who had initially presented with acute asthma exacerbation. The clinical course of hospitalization, surgical and pathological findings were described. We review three previously reported cases of ischemic colitis and bronchial asthma and explore possible mechanisms to explain this association. The complex interaction of smooth muscle tone and autonomic nervous system in the etiopathogenesis of bronchial asthma and ischemic colitis is discussed. Further studies should be undertaken to clarify this association.

Aged↗
PubMed2004

Graves' disease associated with spasmodic truncal flexion.

A 40-year-old Chinese man was admitted with 1-2 Hz spasmodic truncal flexion resembling myoclonus. He was known to be thyrotoxic, and had defaulted antithyroid therapy. Clinical examination revealed truncal flexion from contraction of the rectus abdominis, with no involvement of limbs or face and no jerking in sleep. He was biochemically thyrotoxic. Treatment with clonazepam and propylthiouracil resulted in resolution of the myoclonic jerks within the next 3 weeks. He stopped taking clonazepam within the next 3 months with no recurrence of myoclonus. He remained well until he stopped taking his antithyroid medications 9 months later, when he developed spasmodic truncal jerking again. Biochemical tests confirmed that he was hyperthyroid at this time. These movements ceased within a month of compliance with antithyroid therapy, and he has been well since. MRI of the brain and thoracic spine were unremarkable. Thyrotoxicosis is known to cause chorea and tremors, and has rarely been described in association with myoclonus.

Adult↗
PubMed2004

Generalised myoclonus evolving into epilepsia partialis continua due to a cingulate gyrus lesion: case report and review of the literature.

A young Chinese male was admitted for a generalised tonic-clonic seizure preceded by a week-long history of fever. Subsequently, he developed continuous myoclonic jerks in all four limbs, with clear left sided predominance, and no accompanying clouding of consciousness. Contrast MRI of the brain demonstrated a venous angioma in the right cingulate gyrus. Over the next few days, the clinical picture evolved, with focal motor status involving primarily the left lower limb and the abdomen. These movements resolved with anticonvulsant therapy. This case illustrates generalised myoclonus arising from a focal brain abnormality. The epileptiform aetiology became obvious only after evolution into the typical features of a focal motor seizure and supportive neuroimaging. This demonstrates the protean manifestations of epileptic seizures which have been ascribed to the cingulate gyrus. The lack of clear declarative clinical and EEG features highlights the melding of the fields of epileptology and movement disorders.

Adult↗