Epileptic Seizure: An Atypical Presentation in Brucellosis

Neurologic involvement occurs in approximately 10% cases of brucellosis  and is a serious complication. It manifests with unique and some rare  manifestations. We present the first patient with seizures in Brucella  meningitis without encephalitis, space-occupying lesion, or vascular  involvement. The patient is a 23-year-old man with complaint of seizure.  He had generalized weakness for 2 weeks before. In 1 st day of admission,  he had the second convulsion. Cerebrospinal fluid (CSF) on admission  showed lymphocytic pleocytosis and high protein. Brain magnetic  resonance imaging and computed tomography scan were normal. Further  evaluations resulted a positive Wright, Coombs’ Wright, and 2-  mercaptoethanol (2ME) tests. Specific regimen with rifampin, doxycycline,  and ceftriaxone in the 1 st month then the first two with trimethoprimsulfamethoxazole (TMP-SMX) for 5 months administered. 6 months after  completion of treatment in follow-up he has no seizure, systemic or  localized symptoms.