Sabill Memorial Oration ON LOCAL EPILEPSY.

Holmes, Gordon

doi:10.1016/s0140-6736(00)73503-3

Cited by 38 publications

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“…After an injury to his left foot, however, strong stimulation to his foot provoked focal clonic movements that secondarily generalized. Holmes (8) recognized that peripheral stimulation of a limb of a patient who is subject to motor or sensory epilepsy may excite epileptic symptoms if the corresponding part of the cortex is in an unstable state due to injury or disease. These patients differ from ours because they had known brain lesions before the onset of reflex activation of their seizures after peripheral injuries.…”

Section: Discussionmentioning

confidence: 99%

Epileptogenesis due to Peripheral Injury as a Cause of Focal Epilepsy

et al. 2005

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Summary: Purpose:To report three patients in whom focal epilepsy developed shortly after painful soft tissue injuries to their hands.Methods: Case reports.Results: The attacks started in the injured hand. No evidence was found of an underlying brain lesion by history or from imaging studies.Conclusions: These cases suggest the possibility that the injuries led to a plastic change in the sensory/motor cortex, leading to increased excitability and ultimately to seizures. This suggests that epileptogenesis can occur in response to painful peripheral stimuli in some individuals. Key Words: EpileptogenesisPeripheral injury-Focal seizures-Focal epilepsy-Cortical reorganization.We present three patients in whom focal epilepsy developed shortly after injuries to one hand. Presumably, the injuries led to a plastic change in the sensory/motor cortex, leading to increased excitability and ultimately to seizures. Whether this can occur de novo or requires activation of an underlying lesion remains to be seen. This association de novo has not been reported previously in the literature. CASE REPORTS Patient 1A 23-year-old right-handed man with no significant medical or family history was admitted for assessment of abnormal movements and epilepsy. Five years earlier, he accidentally caught his right hand between the rollers of a machine, sustaining soft tissue injuries. Approximately 24 h later, jerking movements developed, initially involving only his right hand, that lasted ∼2-3 s and recurred >20 times a day. Three months later, he started having nocturnal generalized seizures. Valproate (VPA) and carbamazepine (CBZ) resulted in seizure control but no improvement in the myoclonic jerks. These occurred withAccepted January 23, 2005. Address correspondence and reprint requests to Dr. F. Andermann at Montreal Neurological Institute, 3801 University St., Montreal, PQ, Canada H3A 2B4. E-mail: Frederick.Andermann@mcgill.ca out warning, at rest or during purposeful movement. They were sometimes triggered by startle, causing him to fall and injure himself, but this was not consistent.At the time of admission, his general, neurologic, ophthalmologic, and skin examinations were normal. Initially, it was thought that these events were not epileptic, and anticonvulsant medications (AEDs) were rapidly discontinued during continuous video telemetry. He then had nine stereotyped seizures with stiffening of the whole body, elevation of the right arm, slight head and eye deviation to the right, and secondary generalization. Typically, the movement stopped on the right side before the left. Postictally, he had no focal deficits. EEG seizure onset was obscured by muscle artifact but was followed by rhythmic activity over both hemispheres with parasagittal predominance. During one seizure, these changes were clearly lateralized to the left parasagittal region. Only one generalized myoclonic jerk was recorded during wakefulness and was not associated with any EEG change. No interictal epileptiform activity was found.Brain magnetic resonance ima...

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Section: Discussionmentioning

confidence: 99%

Epileptogenesis due to Peripheral Injury as a Cause of Focal Epilepsy

et al. 2005

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“…Ή οθόνη τοϋ κινηματογράφου εμφανίζει ελαχίστην έκλυτικήν ικανότητα και αί άναφερόμεναι περιπτώσεις κρίσεων έκ τής φωτει νής αΰτης πηγής είναι σπάνιαι (Holmes 1927, Herrlin 1960.…”

Section: κινηματογράφοςunclassified

Η Συμβολη Του Οπτικου Φλοιου Εις Τον Μηχανισμον Της Φωτοευαισθητου Επιληψιας. Κλινικη Και Νευροφυσιολογικη Μελετη

Δημητρακουδη¹

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Εις τον Dr. P. M. Jeavons εκφράζω βαθεϊαν την εύγνωμοσύνην μου δια την διδασκαλίαν του εις την Κλινικήν Νευροφυσιολογίαν, την στοργήν κάί το άμέριστον ενδιαφέρον του. Είναι απειραι al εύχαριστίαι μου προς τον Dr. Ρ. Μ. Jeavons δια την αδειαν συγγραφής της παρούσης ερεύνης y εις τον προγραμματισμον της οποίας } την μελέτην του ύλικοϋ και την άξιολόγησιν των ευρημάτων ή συνεχής τον βοήθεια νπήρξεν πολύτιμος. Τον Dr. G.F.Α. Harding θερμότατα ευχαριστώ διότι με είσήγαγεν εις την Πειραματικήν Νευροφυσιολογίαν και Νευροψνχολογίαν. Ή καθοδήγησίς του εις την μεθοδολογίαν και την ήλεκτρονικήν τεχνολογίαν και ή κριτική των δεδομένων νπήρξεν συνεχής και σημαντική. Τάς τεχνικούς κ.κ. U. Trilloe, D. Roden, L. Downey και E. Queen, την δίδα J. Tidsall, την Ψυχολόγον κ. Κ. Peace και τον κ. R. Hess τον τμήματος της 'Οφθαλμόμετρίας, ευχαριστώ θερμώς δια την βοήθειάν των εις θέματα τεχνικής. 'Εκφράζονται θερμαι αϊ εύχαριστίαι μου προς τους ασθενείς, ή σννεργασία τών οποίων κατέστησεν την παρονσαν μελέτην εφικτήν.

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Thoughts about Seizure Prediction from the Perspective of a Clinical Neurophysiologist

Velis

2008

Seizure Prediction in Epilepsy

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Sabill Memorial Oration ON LOCAL EPILEPSY.

Cited by 38 publications

References 0 publications

Epileptogenesis due to Peripheral Injury as a Cause of Focal Epilepsy

Epileptogenesis due to Peripheral Injury as a Cause of Focal Epilepsy

Η Συμβολη Του Οπτικου Φλοιου Εις Τον Μηχανισμον Της Φωτοευαισθητου Επιληψιας. Κλινικη Και Νευροφυσιολογικη Μελετη

Thoughts about Seizure Prediction from the Perspective of a Clinical Neurophysiologist

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