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Results for “Epilepsy, Complex Partial”
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[Comparison of the clinico-psychological aspects and anatomo-pathological findings in cases of psychomotor epilepsy].
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[Observations on psychomotor epilepsy].
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[Psychomotor epilepsy and temporal epilepsy].
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[Psychomotor epilepsy and temporal epilepsy].
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[Psychomotor epilepsy and temporal epilespy].
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[Psychomotor epilepsy; clinic].
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[Electroencephalographic concept of psychomotor epilepsy].
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[Electroencephalographic conception of psychomotor epilepsy].
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A clinical and epidemiological study of adult patients with epilepsy.
The clinical and epidemiological data of 1054 patients with epilepsy between the ages of 16 and 66 years are described. 70% of the patients were treated in neurological departments, 20% by their general practitioners, while 8% received no treatment. The age-specific prevalence was 430 per 100 000 inhabitants, the same for men and women. Hereditary epilepsies (pyknoleptic absences, juvenile myoclonic epilepsy, epilepsy with awakening grand mal) comprised 16% of all the epilepsies; epilepsies with clinical primary generalized grand mal seizures as the only seizure type 32%, epilepsies with complex partial seizures 25% and epilepsies with simple partial seizures 18%. 8% could not be classified.
Prescience as an aura of temporal lobe epilepsy.
PURPOSE: A patient with a distinct aura of prescience as a manifestation of temporal lobe epilepsy was encountered. The experience prompted a review of this ictal phenomenon among patients attending a tertiary care epilepsy outpatient clinic. METHODS: A computer epilepsy database was searched for patients with simple partial sensory seizures and complex partial seizures with auras. Identified patients had charts reviewed for details of the auras; patients were contacted and asked to provide written descriptions of their experiences. Literature searches (PubMed) were done by using the terms "precognition" or "prescience" and "seizures" or "epilepsy." Standard comprehensive epilepsy textbooks were reviewed. RESULTS: The charts of 218 patients were reviewed from 927 in the database; three had prescience as an ictal feature. The patients' descriptions were very similar in all cases (a profound sense of "knowing" what was going to happen in their environment in the immediate future). The experience was distinct from déjà vu and other psychic experiences. All patients probably have temporal lobe epilepsy. Only one other description of prescience as an ictal feature was found in the literature. CONCLUSIONS: Prescience can occur as an ictal feature of temporal lobe epilepsy and represents a previously underreported psychic phenomenon. The potential lateralizing value of this symptom is yet to be determined.
Resistance to propagation of amygdaloid kindling seizures in rats with genetic absence epilepsy.
PURPOSE: The existence of absence epilepsy and temporal partial seizure pattern in the same patient is an uncommon state. In the present study, we aimed to evaluate whether the process of kindling as a model of complex partial seizures with secondary generalization is altered in rats with genetic absence epilepsy. METHODS: Six- to 12-month-old nonepileptic control Wistar rats and genetic absence epileptic rats from Strasbourg (GAERS) were used in the experiments. One week before the experiments, bilateral stimulation and recording electrodes were implanted stereotaxically into the basolateral amygdala and cortex, respectively. Animals were stimulated at their afterdischarge threshold current twice daily for the process of kindling and accepted as fully kindled after the occurrence of five grade 5 seizures. Bilateral EEGs from amygdala and cortex were recorded continuously during 20 min before and 40 min after each stimulus. RESULTS: All control Wistar rats were fully kindled after stimulus 12 to 15. Although the maximal number of stimulations had been applied, GAERS remained at stage 2, and no motor seizures were observed. The afterdischarge duration in bilateral amygdala and the cortex after the kindling stimulus was shorter in GAERS when compared with control rats. CONCLUSIONS: Occurrence of only grade 2 seizures and no observation of grade 3-5 seizures in GAERS with the maximal number of stimulations would suggest that the generalized absence seizures may be the reason of the resistance in the secondary generalization of limbic seizures during amygdala kindling.
Psychomotor epilepsy and psychosis. II. Electroencephalographic findings (sphenoidal electrode recordings).
The EEG findings in waking, sleep, and sphenoidal electrode recordings in 96 patients with partial epileptic seizures with complex symptoms, who, after a median interval of 18 years developed paranoid/hallucinatory psychosis, were compared with the findings from a group of patients without psychosis, who had had the same type of epilepsy in median 24 years. There were no significant differences between the two groups with regard to median age at onset of epilepsy or complex partial seizures, age, or duration of epilepsy at time of examination. The psychotic patients had a significant preponderance of temporal medio-basal spike foci, recorded on the sphenoidal electrode, indicating deep temporal lobe dysfunction as an important factor in the pathogenesis of psychosis. A significant higher frequency of bilateral and multiple spike foci, together with a significant frequency of slow-wave admixture to the waking background EEG activity, indicated more extensive and severe epileptogenic lesions in the psychotic patients. There was no correlation between psychosis and unilateral EEG-foci in either temporal lobe.
The effect of age on seizure semiology in childhood temporal lobe epilepsy.
PURPOSE: Complex partial seizure is the characteristic seizure type observed in epilepsy arising from temporal lobe structures. The seizure evolution in adult patients is quite stereotyped and well characterized, manifesting initially with an aura, behavioral arrest, and oroalimentary and gestural automatism. A greater variability of semiology including motor features with tonic or myoclonic components, as well as a paucity of automatism, has been reported in young children with temporal lobe epilepsy. The aim of our study was to examine in more detail the effects of age on individual ictal features to be able to determine the critical age when lesional temporal lobe seizure semiology undergoes transition from the pediatric to the more adult-type clinical pattern. METHODS: We performed a video analysis of 83 seizures from 15 children (aged 11-70 months) selected by post-temporal lobectomy seizure-free outcome, looking specifically at the motor and behavioral (nonmotor) manifestations in relation to age of the children. RESULTS: All of the children younger than 42 months had seizures with early and marked motor features, which included tonic and myoclonic components and epileptic spasms. Parallel with age, the frequency of these motor components decreased, and in five of 11 children older than 3 years, motor features were totally absent. Analyzed quantitatively, we saw a linear and inverse correlation of the ratio of motor components with age at monitoring. CONCLUSIONS: These findings support the hypothesis that events in brain maturation significantly affect clinical seizure semiology and may override the more typical localizing features seen in adult-type temporal lobe epilepsy. These findings are important to consider in the early diagnosis of childhood temporal lobe epilepsy.
Presurgical lateralization of seizure focus and language dominant hemisphere with O-15 water PET imaging.
OBJECTIVES: The purpose of this study was to assess the value of same day blood flow PET in both the identification of the language dominant hemisphere and in the lateralization of the epileptic focus in patients who were preoperatively evaluated for complex partial seizures. METHODS: The charts of 24 patients who had temporal lobectomies for seizures were retrospectively reviewed. All PET scans were acquired by using O-15 water tracer (H2(15)O) in both resting and language activation conditions. PET language laterality results were compared to Intracarotid amytal procedure (IAP) results. For epileptic focus lateralizations, regions of interest (ROI) analysis of temporal lobes was performed on resting scans. RESULTS: IAP testing was discordant with PET language mapping in 1 out of 24 cases. This patient had a decline in cognitive abilities as measured by postoperative neuropsychologic testing. For epileptic focus lateralization, the PET was highly sensitive (87%) and specific (100%). Lateralizations with the PET were in agreement with surgical sites in all cases. Eighteen patients (75%) were seizure free and 4 patients (17%) were significantly improved after surgery. CONCLUSION: The results suggest that O-15 water PET is sensitive and specific in both the lateralization of epileptic focus and the language dominant hemisphere and can be a cost-effective and noninvasive method in presurgical evaluation of patients with complex partial seizures.