Epilepsia partialis continua as an atypical presentation of cat scratch disease in a young adult

Cat scratch disease (CSD), caused by Bartonella henselae , is usually a self-limited illness transmitted from cats to humans as a result of a scratch or bite and is associated with lymphadenopathy, fever, fatigue, and sometimes papule at the inoculation site. Unusual presentations include transverse myelitis and encephalopathy. CSD encephalopathy usually occurs several weeks after the acute illness and may be heralded by seizures and status epilepticus. An 18-year-old right-handed previously healthy woman developed increasing difficulty speaking, which lasted several days and was followed by witnessed generalized tonic-clonic seizures. She was seen in another hospital, where a CT scan of the head was performed and showed no abnormalities. She was discharged but continued to have difficulties in speaking associated with twisting of her right lip angle. Subsequently, she had another generalized tonic-clonic episode followed by continuous right facial motor seizures that were difficult to control with antiepileptic drugs. Results of routine blood work, CSF analysis, and initial MRI of the brain were all normal. Multiple sessions …