Table 1 Clinical and neuroimaging features of the cases included in this study
Age, sex | Age at cardiac surgery | Follow-up (years) | Type of cardiac surgery | Time to seizure onset post-surgery | Seizure semiology | Seizure duration | Seizure frequency | NAP EEG | MRI | Therapy | Outcome | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Field Strength | GRE sequences | Microbleeds (number and location) | Leukoaraiosis (Fazekas score) | Cortical infarcts | ||||||||||||
Case 1 | 57, M | 53 | 4 | mitral valve reparation and ring annuloplasty | one week | 1) bitter taste and perioral plus distal left hand fingers paresthesia 2) visual blackening in the left upper visual field quadrant | few second-max 1–2 min | Weekly/ monthly | 1) spikes and slow waves in right PO 2) spikes and slow waves in left FT | 1.5 T | SWI | 3 lobar supratentorial MBs in the subcortical white matter of the right hemisphere | 0 | none | LEV 1500 mg/day | Seizure free |
Case 2 | 74, W | 71 | 3 | aortic biological prosthesis placement | few weeks | cold sensation rapidly ascending from the lower limbs then turning in sensation of heat rising from the chest to the face, associated with fear and bad smell | few minutes | Weekly/daily/multidaily | 1) spikes in right FCT 2) slow and sharp waves in left FT | 1.5 T | SWAN | 0 | 1 | none | LTG 250 mg/die | Seizure free |
Case 3 | 46, M | 32 | 14 | mitral valve replacement with mechanical prosthesis | some weeks | 1) sudden onset of dream-like weird thought with slight anguish followed by intense nausea during few seconds and sometimes associated with olfactory sensation not always unpleasant 2) double and blurred/dark vision prevailing the left part of the visual field | few seconds | Monthly/weekly/daily/multidaily | 1) sharp waves in right PO 2) spikes in left FT | 1.5 T | T2* | 4 lobar supratentorial MBs (3 in the subcortical white matter of the right frontal lobe and 1 cortical right occipital) | 0 | none | LCS 300 mg/die | Marked reduction in frequency and duration |
Case 4 | 48, M | 41 | 7 | ascending aorta replacement with aortic root graft | five days | tingling sensation starting from the right arm and spreading to the right leg | 30–40 s | weekly/daily | sharp waves and spikes in left FP | 1.5 T | T2* | 1 lobar supratentorial MB | 0 | none | LEV 2500 mg/day | Seizure free |