Hyperventilation Induced Focal Seizures in an Adult - A Diagnostic Case Report

Introduction: Hyperventilation induced focal seizures in adults is a rare entity and it often gives a diagnostic clue in cases when most of the investigations are negative.We present a middle aged male with 5 days history of subacute onset headache, frequent anger outburst and irritability followed by seizures.His imaging with MRI Brain, CSF analysis and routine investigations gave no support to the suspected clinical diagnosis of acute encephalitis, but EEG showed typical temporo-occipital onset focal seizures induced by hyperventilation, which paved the way for us to suspect autoimmune etiology.Though serum and CSF autoimmune encephalitis panel was negative, in view of clinically suspected autoimmune encephalitis, a trial of steroids was given along with antiseizure medications.Results: He was considered for slow taper of steroids along with azathioprine, with which he had significant improvement in his symptoms had no recurrence on 6 months of followup. Conclusion:This case highlights the clinical significance of focal seizures induced by hyperventilation in adults and the etiological possibility to be considered particularly when autoimmune antibody panel is negative.