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Biomedical subjects

S Giannakodimos

Publications and source records attributed to S Giannakodimos.

8 recordsLinked to original sources
PubMed1998

Typical absence status in adults: diagnostic and syndromic considerations.

PURPOSE: To study the electroclinical features of typical absence status (TAS) in adults with syndromes of idiopathic generalized epilepsies (IGEs). METHODS: Twenty-one patients with one or more spells of TAS were identified among 136 consecutive adult patients with IGEs. All patients with TAS had comprehensive electroclinical investigations and EEG or video-EEG recorded absences. RESULTS: TAS occurred in 24.4% of 86 patients who had IGEs with typical absences alone or in combination with other seizures presisting in adult life. The prevalence of TAS appeared to be syndrome related, ranging from as high as 57.1% in perioral myoclonia with absences and 46.2% in "phantom" absences with GTCS to as low as 6.7% in juvenile myoclonic epilepsy. A varying degree of impairment of cognition was the cardinal clinical symptom shared in all TAS, but corresponding syndromes of IGE were often betrayed by other symptoms such as eyelid or perioral myoclonia. In phantom absences with GTCS, TAS was more numerous (p < or = 0.05) and more frequently the first overt seizure type (p = 0.006) than in any other IGE. Only in the syndrome of eyelid myoclonia with absences, TAS was always situation related, mainly as a result of antiepileptic drug discontinuation. CONCLUSIONS: The clinical EEG semiology and prevalence of TAS appear to be syndrome related with the highest prevalence in the syndromes of perioral myoclonia with absences and phantom absences with GTCS (p = 0.0024).

Adult↗
PubMed1997

Idiopathic generalised epilepsy in adults manifested by phantom absences, generalised tonic-clonic seizures, and frequent absence status.

OBJECTIVES: To describe the clinical and EEG features of adult patients with very mild absences, late onset generalised tonic clonic seizures, and frequent absence status. METHODS: Patients were referrals to a clinic for epilepsies. They all had clinical assessment and EEG, video EEG, or both for documentation of absences. RESULTS: Of 86 adults with idiopathic generalised epilepsies and EEG/video-EEG documented absences, 13 patients showed similar clinico-EEG features with: (a) "phantom absences" consisting of mild ictal impairment of cognition associated with brief (3-4 s), generalised 3-4 Hz spike/multiple spike and slow wave discharges; (b) infrequent, mainly late onset, generalised tonic clonic seizures, and (c), absence status which occurred in six of them either in isolation or terminating with generalised tonic clonic seizures. None of the patients had myoclonic jerks or photosensitivity. Two patients were father and daughter and another patient had a family history of infrequent generalised tonic clonic seizures. CONCLUSION: It seems that this is an idiopathic generalised epilepsy syndrome in adults which has not been previously recognised.

Adolescent↗
PubMed1996

Eyelid myoclonia with absences in adults: a clinical and video-EEG study.

We report clinical and video-EEG findings in 11 adults with the syndro me of eyelid myoclonia with absences (EMA). Prevalence was 2.7% among all epilepsies and 12.9% among idiopathic generalized epilepsies (IGE) with typical absences. All patients with EMA were women, with a mean age of 30.9 years and a mean age of 7.8 years at reported onset of eyelid myoclonia. The characteristic seizures, studied with video-EEG in 10 patients, began with and were mainly manifested by eyelid myoclonia, either alone if brief (< or = 2 s) or with associated mild impairment of consciousness if longer. The ictal EEG was characterized by polyspike and slow waves at 3-6 Hz. Ictal clinical and EEG manifestations occurred mainly after eye closure and were inhibited by total darkness. All patients were photosensitive, but photosensitivity decreased with age; nonpatient had self-induced seizures. Infrequent generalized tonic-clonic seizures (GTCS) occurred in all but the youngest patient; they were usually infrequent and were precipitated mainly by flickering lights, sleep deprivation, fatigue, and menstruation. Mild myoclonic jerks of the upper limbs occurred in 6 patients. Eyelid myoclonia was resistant to medication and persisted despite control of other seizures.

Adolescent↗
PubMed1995

Evaluation of the "monolog" spike and wave monitor: a study on patients with typical absences.

The aim of this study was to evaluate the effectiveness and accuracy of the "monolog," a pocket-size spike and wave monitor, in patients with typical absence seizures. Two observers were scoring independently and blindly from the monitor the number and duration of the 3 Hz spike-wave discharges from the EEG recordings of 10 selected patients having typical absences. High correlation was found between the two observers' scorings for both the number and the mean duration of events (Spearman's rank correlation (r): 0.9970, P < 0.001, and 0.9758, P < 0.001), as well as between each of them and the "monolog" for the mean event duration (r: 0.9848, P < 0.001, and 0.9788, P < 0.001). Conversely, a poor correlation was found between each of the observers and the "monolog" for the number of events (r: 0.7121, P = 0.021, and 0.6939, P = 0.026). In conclusion, the "monolog" accurately measured the duration of 3 Hz spike-wave activity; however, it failed to accurately count the number of events that occurred throughout the recordings. We suggest that this device, with appropriate modification to its memory epochs, may be a useful tool in monitoring patients with typical absences.

Brain↗
PubMed1995

Qualitative and quantitative abnormalities of breath counting during brief generalized 3 Hz spike and slow wave 'subclinical' discharges.

We aimed to validate the technique of breath counting during overbreathing in revealing ictal impairment of cognition during brief generalized 3 Hz spike and slow wave discharges. A retrospective study of 66 patients with video-electroencephalographic documentation of typical absence seizures revealed 8 patients in whom there was no clinical suspicion of absences but who had brief (less than 4 seconds) generalized 3 Hz spike-wave discharges. The only clinical manifestations of the absences were abnormalities in breath counting during overbreathing. These consisted of slowing of speech, delay in counting, repetition of numbers and counting out of sequence combined with delay. Abnormalities were more likely to occur during longer discharges. Detection of these abnormalities led to important changes in the classification of the patients' epilepsies and in the recommendations for treatment. The technique of breath counting during overbreathing is a simple practical and reliable method for detecting even mild cognitive impairment during 3 Hz spike-wave discharges.

Adult↗
PubMed1995

Posterior agyria-pachygyria with polymicrogyria: evidence for an inherited neuronal migration disorder.

We describe two brothers with mental retardation and refractory epilepsy. MRI revealed symmetrical agyria-pachygyria of the temporo-occipito-parietal regions, areas of deeply infolded polymicrogyric parietal cortex, and dilated occipital horns (colpocephaly). The stereotyped clinical, EEG, and MRI findings suggest that this may be a distinct inherited condition and imply that agyria-pachygyria with polymicrogyria is not always sporadic.

Brain↗
PubMed1994

Video game induced seizures.

Fifteen patients who experienced epileptic seizures while playing video games are described together with a review of 20 cases in the English literature. Nine of the 15 cases and all but two of the reported cases experienced their first seizure while playing video games. Two thirds of patients had idiopathic generalised epilepsy and mainly reported generalised tonic clonic seizures, but some had typical absence seizures and myoclonic jerks while playing video games. In this series, 30% with idiopathic generalised epilepsy had juvenile myoclonic epilepsy. Overall, 70% of patients with idiopathic generalised epilepsy were photosensitive to intermittent photic stimulation and the mechanism of seizure provocation was probably similar to that of television induced seizures, although sensitivity to specific patterns was sometimes important. Two children had self induced video game seizures. Non-photic factors such as excitement, fatigue, sleep deprivation, cognitive processing, and diurnal variation in susceptibility seemed to be important seizure precipitants, particularly in non-photo-sensitive patients. Twenty nine per cent of patients had partial (mainly occipital) video game associated seizures. Occipital spikes were common in the EEG of these patients. Photosensitivity to intermittent photic stimulation may have been important in two patients but in the others, who all played arcade video games, other mechanisms need to be considered. Video game associated seizures are a feature of several epileptic syndromes and differ in precipitants and appropriate management.

Adolescent↗