Prolonged focal epilepsy and hypoxemia as a cause of focal brain damage: A case study

A 48‐year‐old woman developed epilepsia partialis continue (EPC) involving the right arm and leg, which lasted for four weeks until she died. Systemic hypoxia associated with chronic obstructive pulmonary disease and acute pneumonia complicated her hospital course. At autopsy, diffuse cortical changes resembling the sequelae of ischemic anoxia were observed in the left cerebral hemisphere. The right cerebral hemisp here and cerebellum were minimally involved. No other significant pathological processes could be identified in the central nervous system, and the cerebrovascular system was free of obstructive lesions. It is proposed that the left‐sided damage was precipitated by the increased metabolic demand of the cerebral cortex associated with the EPC, with which autoregulatory circulatory responses were unable to cope in a patient with underlying hypoxia.