Hemispheric differences in the duration of focal onset seizures

Abstract

Objective To assess hemispheric differences in the duration of focal onset seizures and its association with clinical and demographic factors. Methods A retrospective analysis was performed on adult patients with drug‐resistant unifocal epilepsy, who underwent intracranial EEG recording between 01/2006 and 06/2016. Seizure duration was determined based on the subdural and/or stereo‐EEG (sEEG) recordings. Hemispheric differences in seizure duration were statistically evaluated with regard to clinical and demographic data. Results In total, 69 patients and 654 focal onset seizures were included. The duration of seizures with left‐hemispheric onset (n = 297) was by trend longer (91.88 ± 93.92 s) than of right‐hemispheric seizures (n = 357; 71.03 ± 68.53 s; p = .193). Significant hemispheric differences in seizures duration were found in temporal lobe seizures (n = 225; p = .013), especially those with automotor manifestation (n = 156; p = .045). A prolonged duration was also found for left‐hemispheric onset seizures with secondary generalized commencing during waking state (n = 225; p = .034), but not during sleep. A similar hemispheric difference in seizure duration was found in female patients (p = .040), but not in men. Conclusions Hemispheric differences in seizure duration were revealed with significantly longer durations in case of left‐hemispheric seizure onset. The observed differences in seizure duration might result from brain asymmetry and add new aspects to the understanding of seizure propagation and termination.

Duration of epileptic seizure types: A data‐driven approach

“…Our study results on EEG duration for electroencephalographic seizures are shorter than what has been reported in previous studies, 13 , 33 , 46 , 47 , 48 which could be due to those studies using intracranial recordings, and the patients having refractory epilepsy and undergoing antiseizure medication withdrawal due to epilepsy surgery workup.…”

“…We found an opposite trend, with focal aware seizures lasting less than those with impaired awareness. Kauffmann et al 32 and Seethaler et al 46 also report that most focal seizures terminate within 2–3 min. Although most focal seizures terminate within 4 min, we recorded seizures lasting up to 9 min (median for a single patient), indicating that the T1 time point proposed by Trinka et al 6 for focal impaired awareness SE set at 10 min is appropriate.…”

Incidence, temporal profile and neuroanatomic correlates of poststroke epilepsy

“…In our VLSM study, only left‐hemispheric, not right‐hemispheric, stroke lesions were associated with PSE. Hemispheric differences in the occurrence of epilepsy and seizure duration have been shown in previous work 34,35 . The group of Scott et al.…”

Avaliação do perfil de disfunção cognitiva de pacientes pediátricos com epilepsias do córtex posterior de difícil controle farmacológico

“…Embora não significativa, houve uma maior frequência de ZE localizada no HCE em pacientes com ECP (61,5%) e ELT (65,6%). Este achado é similar ao encontrado por outro estudo, que descreveu predominância da ZE no HCE em 63,1% dos pacientes adultos com ELT (SEETHALER et al, 2021). Ainda assim, não há consenso na literatura sobre uma maior propensão do HCE ou lobos cerebrais específicos à epileptogênese (HOLMES et al, 2001).…”

“…There was a significant effect of the brain region on the Digit Although not significant, there was a higher prevalence of seizures in the left hemisphere (LH) in patients with TLE (60%) and PCE (56%). Another study described the predominance of EZ in the LH in 63.1% of adult patients with TLE [14]. Still, there is no consensus on a greater propensity for LH or brain lobes specific to epileptogenesis [15].…”