Misdiagnosis of Complex Absence Seizures

So, Elson L.; King, Don W.; Murvin, Alice J.

doi:10.1001/archneur.1984.04210080048012

Cited by 19 publications

(14 citation statements)

References 5 publications

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“…These findings do not fit any of the physiopathological models developed following the first investigations on IPS by Grey Walter et al in 194625 or by others. 7 26 The findings are consistent with the idea of a "loose" relationship between brain function and surface EEG.27 28 Another aspect that is worth noting is that the duration of the evoked discharges did not have a predictive value concerning the type of clinical symptoms: jerks in the whole body were seen during generalised discharges of 0 5 seconds duration as well as of 8 seconds. The reduction of consciousness was the only variable clearly related to the length of discharges.…”

Section: Discussionmentioning

confidence: 55%

Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life.

Trenité

Binnie

Meinardi

1987

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Thirty six patients were studied with a classical photoparoxysmal EEG response to intermittent photic stimulation (IPS). Clinical observations and complaints reported by patients during standardised IPS were recorded and compared with historical data. Twenty seven patients experienced impaired consciousness or showed motor phenomena such as involuntary opening of the eyes or jerking on one or both sides of the body. Twenty five patients had sensations such as pain in the eyes, jerking etc. There existed no relation between the duration of the evoked discharges (0 5-3 seconds) and observed signs or complaints. In 11 instances the clinical features found during IPS were not reported in a history taken from the patient and relatives. In the case of spontaneous epileptiforn EEG discharges it is generally accepted that there is a relation between the duration of the discharge and the occurrence of observable clinical features. If generalised spike-wave discharges last less than 3 seconds, they often pass unnoticed by the patient and the observer. " 12 However, it is not known whether photically-induced epileptiform activity differs in this respect from spontaneous discharges. In a previous study of 38 photosensitive patients we found that 39% reported various forms of ocular discomfort (sore eyes, headache, etc.) induced by potentially epileptogenic stimuli, such as disco lighting and the sun shining through trees or on water.13 It is unknown whether subjective complaints during IPS' "1 have any relation to clinical features during IPS or to visually-induced seizures in daily life. We have therefore prospectively examined an unselected group of photosensitive patients, with particular attention to subjective and objective clinical events during IPS.

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Section: Discussionmentioning

confidence: 55%

Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life.

Trenité

Binnie

Meinardi

1987

Journal of Neurology, Neurosurgery & Psychiatry

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“…19 Our analysis shows that Lennox's use of "petit mal" corresponds almost completely to the contemporary meaning of absence seizures. For example, the term "petit mal" is sometimes used loosely for any "small" seizure.…”

Section: Discussionmentioning

confidence: 82%

Epilepsy in twins

et al. 2004

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“…12 Complex partial seizures of frontal lobe origin can also mimic absences; clinical, EEG, or radiologic features pointing to a frontal focus usually lead to correct diagnosis.13-'8 Sometimes, however, an occult frontal focus, especially on the medial surface of one hemisphere, can cause brief seizures with generalized spikewave discharges on EEG, and distinction from true absences can be d i f f i c~l t .~~J 9 -~~ Absences are invariably accompanied by an ictal EEG signature of generalized, bilaterally synchronous spike-wave discharges at 1.5 to 4 Hz.8-10J4,23,24 There are occasional reports of absences associated with generalized rapid spikes at 8 to 20 H z .~~~~~ The classification of these latter seizures is arguable; most are probably best regarded as generalized tonic seizures27 and some may be partial seizures from occult frontal foci.lg Causes of absence seizures. The clinical features of absences are well knownss9 and have been meticulously described by videotape analyses.lOJ1 Distinction from daydreaming and from inattentiveness due to psychological disturbances is usually straightforward.…”

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confidence: 99%

Concepts of absence epilepsies

Berkovic¹,

Andermann²,

Andermann³

et al. 1987

Neurology

215

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There are two current approaches to the clinical conceptualization of the generalized epilepsies. The syndromic approach attempts to subdivide the patient population into relatively homogeneous groups, largely on the basis of clinical and EEG criteria. In contrast, the neurobiological approach aims to formulate a unique profile for each patient by incorporating particulars of the patient onto the background of knowledge regarding the etiologic factors important in generalized epilepsy. The value of these two approaches is discussed with regard to the dual aims of, first, improving the understanding of generalized epilepsy, and second, providing a precise diagnosis, an accurate prognosis, and optimal treatment for the patient.

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Misdiagnosis of Complex Absence Seizures

Cited by 19 publications

References 5 publications

Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life.

Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life.

Epilepsy in twins

Concepts of absence epilepsies

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