Hyperkinetic Seizures with Ictal Fear as Localizing Ictal Signs in MRI-Negative Medial Frontal Lobe Epilepsy.
Neuropediatrics
; 52(1): 44-47, 2021 02.
Article
em En
| MEDLINE
| ID: mdl-32842161
ABSTRACT
PURPOSE:
Hyperkinetic seizures are described as seizure onset in the frontal or temporal lobe. Additional localizing information is important for diagnostic workup and surgical therapy. We describe diagnostic workup and surgical outcomes in three patients with pharmacoresistant focal emotional seizures with hyperkinetic elements. METHODS/RESULTS:
High-resolution 3 Tesla (T) magnetic resonance imaging (MRI) did not reveal clear-cut lesions. Invasive video-electroencephalography (EEG) with depth electrodes along the cingulate sulcus (bilateral; patients 1 and 3), right; patient 2 provided congruent results for a circumscribed seizure onset zone within the medial frontal lobe (right patients 1 and 2; left patient 3). Topectomies were performed in all patients. Histopathology revealed a small focal cortical dysplasia in the three cases (focal cortical dysplasia [FCD] IIA patient 1; FCD IIB patients 2 and 3). All patients remained completely seizure-free since surgery (Engel 1A; follow-up 9-28 months).CONCLUSION:
Ictal fear associated with hyperkinetic semiology points to a seizure-onset zone within the anteromedial frontal lobe (anterior cingulate gyrus). Ictal semiology is crucial for the placement of depth electrodes, especially in MRI-negative cases. These cases illustrate a clinical advantage to the new International League against Epilepsy (ILAE) seizure classification, emphasizing initial clinical symptoms.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Epilepsia do Lobo Frontal
/
Malformações do Desenvolvimento Cortical
/
Medo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Neuropediatrics
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha