A case of seizures, orofacial dyskinesias, and peripheral neuropathy

CASE PRESENTATION A 31-year-old woman presented to us with a 7-year history of neurological complaints. She was a product of a normal, but somewhat difficult birth, and during the first year of her life she had experienced febrile seizures. At the age of 24 years she experienced the first grand-mal seizure of her adult life. She was not aware of any other seizures, with the possible exception of a single episode of a metallic taste and a few staring spells. She was subsequently placed on successive antiepileptics (including phenytoin, carbamazepine, phenobarbital, and gabapentin) that she had to discontinue due to side-effects (i.e. drowsiness, allergic skin reactions, elevated liver enzymes). Finally she was placed on sodium valproate that was well tolerated at a dose of 750 mg/day.