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Biomedical subjects

A Bonis

Publications and source records attributed to A Bonis.

At least 19 recordsLinked to original sources
PubMed1992

Surgical therapy for frontal epilepsies.

We have described our 25 years experience concerning 100 patients operated on for frontal epilepsy. Results show that 55% of patients are practically cured of their seizures and that 76% benefited from cortectomy (reduction of more than 75% of seizures). These results are the worst in the total series of St. Anne. Reasons for success and especially failure were analyzed in detail: 1. SEEG methods gave good indications along three dimensions of the limits and borders of the cortical excision. 2. When clinical semiology and organization of ictal discharges give evidence for rapid bilateral discharge, with involvement of axial musculature and generalized tonic-clonic manifestations, experience shows that it is necessary to combine cortectomy with a section of the adjacent cortico-subcortical fibers of the corona radiata, as if propagation of ictal discharges were impeded if not interrupted by sectioning such fibers and the primary site were incapable of expressing itself clinically. 3. If the characteristics of seizures suggest the quasisimultaneous involvement of the two frontal lobes and the existence of bilateral multifocal epilepsy, we suggest that a systematized anterior callosotomy might lead to useful results. 4. Finally, we propose general criteria for indications and contraindications for surgery.

Adolescent↗
PubMed1984

Somatomotor manifestations in temporal lobe seizures.

Some authors include somatomotor manifestations (SMM) among the clinical features of temporal lobe seizures in man; however, data are limited and conflicting. This study describes 101 seizures recorded during stereo-EEG explorations in 50 patients, selected on the basis of the demonstration of onset in temporal lobe structures (stereo-EEG) and the presence of lateralized SMM and/or secondary generalization (SG). SMM and SG were present in about 20% of our population of patients with temporal seizures explored with stereo-EEG, and were only rarely observed during the first 10 s (early SMM) of the seizures (less than 10%). Seizures characterized by early SMM were generally induced by electrical stimulation or chemical activation and only exceptionally spontaneous. In all cases the ictal electrical discharge also involved at an early stage extratemporal structures such as the rolandic operculum, the parietal lobe, or contralateral temporal structures. In most cases (greater than 90%) SMM represented a late (greater than 10 s) event in the ictal symptomatology. The face and the upper limb were by far the most frequently involved segments. Thirty-eight percent of seizures ended up in SG. The associated ictal symptomatology was rather poor and differed from our previous findings in temporal lobe seizures: oroalimentary automatisms were relatively rare, whereas an impairment of consciousness was observed in more than 50% of seizures. The critical electrical discharge had a long duration and always involved extratemporal structures in one or both hemispheres. The involvement of the central region could be demonstrated in all patients with deep electrodes in that region. In conclusion, SMM are not characteristic of temporal lobe seizures, and their presence indicates spreading of the critical discharge beyond the temporal lobe.

Adolescent↗
PubMed1982

Prevalence of psychosis in epilepsy as a function of the laterality of the epileptogenic lesion.

Retrospective analysis of the psychiatric diagnoses in a group of patients surgically relieved of medically intractable epilepsy tested the hypothesis that patients with left-sided temporal lobe epileptogenic lesions are at greater risk for the development of a so-called schizophrenic-like psychosis than are those with right-sided temporal lobe epileptogenic lesions. The data confirmed the hypothesis and also demonstrated an increased prevalence of sinistrals in the psychotic group. Thus, epilepsy involving the dominant hemisphere at the inception of the seizure disorder is the significant risk factors. The data also indicated that a psychosis is unlikely to develop in patients with other (nontemporal) forms of focal epilepsy. On the basis of these data and data from other studies, the prevalence of psychosis in patients with poorly controlled temporal lobe epilepsy was estimated to be approximately 10% to 15%.

Adult↗
PubMed1982

[Motor and postural manifestations of temporal lobe epilepsy seizure].

This study reports on 73 epileptic seizures (in 36 patients) originating in the temporal lobe (stereo-EEG) presenting motor or postural signs. Motor symptoms occur rarely in the early phase of seizures (less than 10% of our series) and they are exceptional during spontaneous seizures. The critical electrical discharge always affects extra-temporal structures such as the rolandic operculum, the cingulate gyrus, etc. The occurrence of motor symptoms during the late phase of seizures is associated with a long duration of the critical discharge and, again, with the involvement of extra-temporal structures. The characteristics of the associated clinical signs (e.g., frequent loss of contact with the environment, relatively rare oroalimentary automatic activities), together with the high frequency of secondary 'generalizations' are consistent with the stereo-EEG findings and indicate that these seizures also affect extra-temporal regions.

Adolescent↗
PubMed1982

[Continuous partial epilepsy: syndrome and disease].

Twenty three patients are described with a Kojewnikow syndrome in order to identify possible etiological factors. According to their history, clinical and E.E.G. features, patients could be classified into two groups; 1) Eleven patients corresponded to the classical description of the Kojewnikow syndrome: variable age at onset of the disease, rare somatomotor seizures, delay of onset of myoclonic jerks often of long duration, myoclonus limited to a small region, normal neurological examination, stable hemiplegia, normal results of psychometric tests, localised E.E.G. alterations. In most of these patients the etiology of the disorder was known, and the symptoms could be related to a localised lesion of the central cortex; 2) the second group (11 patients) presented with completely different characteristics: early onset of fits (age: 2 to 10 years), presence of other seizure types, short delay of onset of myoclonic jerks, high frequency of seizures, localization of myoclonus over large parts of the body, progressive evolution of a motor syndrome, associated neurological signs and disorders of sleep and behavior, progressive mental deterioration, characteristic E.E.G. pattern with long subclinical paroxysms of slow spikes (sharp waves) with variable localization, diffuse cerebral lesions of unknown etiology were found. Only one patient could not be allocated to either group. Several circumstantial data suggest that patients of the second group may suffer from a slow virus infection. Should this hypothesis be confirmed, a reconsideration of the Kojewnikow syndrome from the etiological standpoint would be of great theoretical and practical interest.

Adolescent↗
PubMed1979

[Epilepsy and psychoses (from the viewpoint of a neurosurgical service)].

The experience of a neurosurgical unit devoted to the surgical therapy of the epilepsies is only based on very peculiar patients. However, relationship between a given epilepsy and associated psychiatric disorders are more easily understood because of more extensive explorations. Bilateral temporal epilepsies involving the limbic system on the one hand, bilateral frontal epilepsies on the other one, and P.M. status which may be paralleled, make these patients more susceptible to acute mental confusions, to acute thymic disorders, to delirious attacks. Direct relations between chronic psychosis and severe epilepsies are much more uncertain.

Brain Diseases↗
PubMed1977

Ictal tonic postural changes and automatisms of the upper limb during epileptic parietal lobe discharges.

Tonic postural changes of the upper limb accompanied by epileptic parietal lobe discharges are not well known. The authors report 3 such cases. In the 3 patients, a total of 18 spontaneous seizures were recorded, 12 by telemetry, from either scalp electrodes or stereotactically implanted electrodes. Of these 18 seizures, 14 included tonic postural changes of the upper limb accompanied by a contralateral parietal discharge. Combining these 3 cases with the 4 such cases in the literature, the authors found that the clinical pattern consisted of a tonic postural change in one upper limb associated with automatisms of the opposite upper limb. It was also found that the same patient might have automatisms involving the upper limb in some seizures and upper limb postural changes in other seizures, both accompanied by the same electrical discharge. It is concluded that tonic postural changes and automatisms in the upper limb may be interchangeable.

Adult↗
PubMed1977

The seizures of frontal lobe epilepsy. A study of clinical manifestations.

We describe ictal clinical manifestations of frontal lobe epileptic seizures in 22 patients. After examination of all ictal clinical data, 14 catergories of signs and symptoms were established. The validity of the ictal clinical data used was confirmed on the basis of 99 frontal lobe seizures recorded by tele-electroencephalogram or tele-stereo-electroencephalogram. The main conclusion is that the frontal lobe appears to be partially connected with motor acitivity.

Adolescent↗
PubMed1976

Automatisms during frontal lobe epileptic seizures.

Three new cases of automatisms occurring during frontal lobe epileptic seizures are reported. If these cases are added to those already published and adequately described in the literature, a total of 12 cases is obtained. An attempt is made to elucidate the clinical characteristics of automatisms encountered during frontal lobe seizures. This kind of automatism would seem to be clinically distinguishable from other types.

Adolescent↗
PubMed1976

[Behavioral manifestations induced by electric stimulation of the anterior cingulate gyrus in man].

The electrical stimulation of a restricted part of area 24 in awake man elicits important behavioral changes. The present study is dealing with 83 epileptic patients whose brain activity was recorded in SEEG conditions, with a view to possible neurosurgery. In order to determine how seizures originate and propagate, 116 multileads electrodes (65 right, 51 left) were stereotaxically inserted in the anterior part of the cingular gyrus. 521 stimulations were performed. In 362 cases, this stimulation induced a particular behaviour which was characterized by an arousal, motor activities (involving fingers and hand, mouth, legs, eyes, associated movements of hand mouth, highly integrated movements), thymic modifications and hallucinatory manifestations. Topographical organization of the effective area in the cingular gyrus and the relation between the electrical responses and stimulation parameters are studied.

Adolescent↗
PubMed1975

Clinical note: clinical and tele-stereo-EEG findings in a patient with psychomotor seizures.

A patient was studied who had posttraumatic epilepsy with adversive, psychomotor, and grand mal seizures. During tele-EEG recording from depth electrodes, 4 psychomotor seizures were accompanied by discharge originating in the frontal lobe. The patient sometimes could recall his behavior and believed it to be voluntary. Amnesia was more apt to be total after the seizure than during it.

Adult↗
PubMed1975

[Neurophysiopathological hypothesis on startle epilepsy in man].

Clinical observation and S.E.E.G. recordings performed with a surgical purpose in a typical case of startle-epilepsy has led to a reassessment of the relationship of this form of epilepsy and "Startle reaction". It is confirmed that the critical discharges take origin in the primary motor cortex. The authors discuss, in the light of experimental data already published, the physiopathological hypotheses likely to lead to a better understanding of startle epilepsy. On the one hand it is suggested that the startle reaction may be responsible through a feed-back mechanism for triggering the epileptogenic focus. On the other hand it is assumed that afferent pathways, central organization and efferent systems involved in startle reaction and actual fits are different.

Adult↗