The localizing value of auras in partial seizures

Palmini, André; Gloor, P.

doi:10.1212/wnl.42.4.801

Cited by 192 publications

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“…The low incidence of auras is also reported by other video-EEG studies 9,19 , and it can be related to some patients' inability to report them after secondarily generalized seizures related to antiepileptic drug reduction with a larger incidence of retrograde amnesia 20 . The significant increase of the aura percentage, when we considered the presence of indicative signs, may suggest the need of their inclusion in video-EEG studies.…”

Section: Discussionsupporting

confidence: 52%

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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-The analysis of the temporal lobe seizures through video-EEG systems shows that they often consist of a sequence of clinical and EEG features which may suggest the localization and the lateralization of the epileptogenic lobe. We analyzed clinical and EEG features of 50 temporal lobe seizures which were separated in group 1 with 25 patients (related to mesial temporal sclerosis) and group 2 with 25 patients (other neocortical temporal lesions). Among the auras, the epigastric type was the most frequent and predominated in group 1. There were differences between the two groups, considering dystonic and tonic posturing and versive head and eye movements. Dystonic posturing was always contralateral to the ictal onset and was considered the most useful lateralizing clinical feature. Ictal speech, spitting and blinking automatisms, prolonged disorientation for place and a greatest percentage of postictal language preservation occurred in right temporal seizures. Postictal aphasia and global disorientation predominated in left temporal seizures. EEG was important for lateralizing the epileptogenic lobe, specially considering rhythmic ictal activity and postictal findings.KEY WORDS: temporal lobe epilepsy, complex partial seizures, video-EEG.Análise clínica e eletrencefalográfica de crises epilépticas temporais de origem mesial e lateral RESUMO -As crises epilépticas do lobo temporal tendem a seguir uma sequência previsível de eventos clínicos e eletrencefalográficos, cuja análise, preferencialmente através de sistemas de vídeo-EEG, sugere a localização e a lateralização do lobo epileptogênico. Para este estudo, foram analisadas 50 crises epilépticas do lobo temporal, do ponto de vista clínico e eletrencefalográfico, sendo 25 relacionadas a esclerose mesial (grupo 1) e 25 a patologias neocorticais (grupo 2). Auras abdominais foram as mais frequentes, predominando no grupo 1. Houve diferenças entre os dois grupos, quanto à instalação e duração da postura distônica, à postura tônica e à versão oculocefálica. Postura distônica unilateral foi o mais importante fenômeno clínico lateralizatório, sempre contralateral à área epileptogênica. Verbalização crítica, automatismo de cuspir, piscamento palpebral bilateral, desorientação espacial prolongada e maior percentual de preservação da linguagem no período pós-crítico foram relacionados a crises temporais direitas. Afasia pós-crítica e desorientação global, a crises temporais esquerdas. O EEG teve importante acurácia lateralizatória em ambos os grupos, especialmente quanto à atividade crítica rítmica e achados pós-críticos. PALAVRAS-CHAVE: epilepsia do lobo temporal, crises parciais complexas, vídeo-EEG.According to the International Classification of Epilepsies and Epileptic Syndromes 1 , these can be divided in partial, generalized, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. Temporal lobe epilepsy (TLE) is responsible for 60% of all the partial epileptic seizures 2 and it has been extensively studied clinically, electr...

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Section: Discussionsupporting

confidence: 52%

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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“…Ictal headaches can occur with seizures as the sole or predominant clinical manifestation. 30 Isler and colleagues 31 showed that hemicranial attacks of pain coincided with seizure activity and typically lasted seconds to minutes (hemicrania epileptica); in rare cases, ictal headache can last for hours.…”

Section: Temporal Coincidence Of Migraine and Epilepsymentioning

confidence: 99%

Chronic disorders with episodic manifestations: focus on epilepsy and migraine

Haut¹,

Bigal²,

Lipton³

2006

The Lancet Neurology

275

213

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Epilepsy and migraine are chronic neurological disorders with episodic manifestations that are commonly treated in neurological practice and frequently occur together. In this review we examine similarities and contrasts between these disorders, with focus on epidemiology and classification, temporal coincidence, triggers, and mechanistically based therapeutic overlap. This investigation draws attention to unique aspects of both epilepsy and migraine, while identifying areas of crossover in which each specialty could benefit from the experience of the other.

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“…In this study, we defined LRE patients as those having interictal focal spikes and at least one unprovoked partial seizure or secondarily generalized seizure. The anatomic classification of LRE was based on concordance of the localization indicated by at least two of the following: (a) Interictal EEG findings; (b) computed tomography (CT) scan or magnetic resonance image (MRI) findings, or both; (c) single-photon emission CT (SPECT) scan findings; and (d) auras and clinical seizure manifestations indicating a specific localization (23,24). We tentatively defined epilepsy remission as a seizure-free period of 2 2 years.…”

Section: Subjectsmentioning

confidence: 99%

Study on the Early‐Onset Variant of Benign Childhood Epilepsy with Occipital Paroxysms Otherwise Described as Early‐Onset Benign Occipital Seizure Susceptibility Syndrome

et al. 1999

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Summary: Purpose: We studied the early-onset variant of benign childhood epilepsy with occipital paroxysms (EVBCEOP) proposed by Panayiotopoulos, to confirm whether his five criteria are sufficient to delineate EVBCEOP as a new epileptic syndrome, as well as to predict a good outcome prospectively at the time of the first examination.Subjects: The subjects were 649 children with localizationrelated epilepsies (LREs) observed in our hospital for >4 years.Methods: We applied the International Classification of Epilepsies and Epileptic Syndromes to the 649 patients and identified patients who had EVBCEOP from among those with nonspecific idiopathic LRE. The inclusion criteria were to satisfy all five criteria and all but one criterion (i.e., either ictal vomiting or occipital EEG paroxysms). We were blind as to the outcomes and selected patients who satisfied the following teria, 22 who exhibited all but occipital EEG foci, and 2 1 who exhibited all but ictal vomiting. The incidence of status convulsivus was higher in those with ictal vomiting than in those without ictal vomiting (p < 0.05). Interictal EEG performed every 6 months showed shifting and multiplication of EEG foci in 42 and 52% of all subjects, respectively. We identified 57 patients, 42 (74%) of whom were in remission by age 12 years. The number of patients who experienced remission did not differ significantly between those with (76%, n = 25) and without (72%, n = 32) ictal vomiting (p > 0.05). Conclusions:Nosologically, EVBCEOP appears to constitute the earliest form of idiopathic epileptic syndrome different from classic BCEOP. However, its clinical spectrum, ranging from the absence of ictal vomiting to a combination of extraoccipital and multifocal EEG foci, is broad, such that further three of the five criteria at the time of the first examination, (a) normal development before the onset, (b) epilepsy onset age between 2 and 8 years, and (c) occipital EEG foci. We attempted to determine whether the outcome can be predicted prospectively, and whether the presence or absence of ictal vomiting affects the prognosis.Results: We identified 19 patients who satisfied all five criprospective study is expected to reveal the exact prerequisite criteria for determining the border of this epileptic syndrome and for clarifying the clinical spectrum within this syndrome. Key Words: Early-onset variant of benign childhood epilepsy with occipital paroxysms-Migrating EEG foci-Ictal vomiting-Idiopathic localization-related epilepsy-Occipital EEG foci.Panayiotopoulos proposed classifying benign childhood epilepsy with occipital paroxysms (BCEOP) into early-onset and late-onset types based on the results of his 15-year prospective follow-up study of children with occipital paroxysms (1-8). In his proposal, the latter is classified as BCEOP (9), which Gastaut originally defined, and visual seizures are the predominant seizure type. The early-onset type has been proposed to be a new idiopathic epileptic syndrome, characterized by the fol-~ ~~~

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The localizing value of auras in partial seizures

Cited by 192 publications

References 0 publications

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Chronic disorders with episodic manifestations: focus on epilepsy and migraine

Study on the Early‐Onset Variant of Benign Childhood Epilepsy with Occipital Paroxysms Otherwise Described as Early‐Onset Benign Occipital Seizure Susceptibility Syndrome

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