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2.
Artigo em Russo | MEDLINE | ID: mdl-31626212

RESUMO

AIM: To study the pathomorphosis of idiopathic generalized epilepsies (IGE) in a large population of adult patients with long-term follow-up. MATERIAL AND METHODS: The study involved 1480 patients with epilepsy, including 281 patients with IGE. RESULTS: In 26 patients with childhood absence epilepsy (CAE), age-related changes in disease course have been particularly pronounced. None of the patients had frequent typical absences ('pyknolepsy') at the time of the survey. Sixteen of 26 patients had predominantly rare generalized tonic-clonic seizures in combination with occasional absences or myoclonic jerks, while in 2 patients there was the transition from the DAE to juvenile myoclonic epilepsy (JME). The EEG recorded in the 'adult' age showed the level of epileptiform activity in only 12 patients out of 26 (in 2 patients only during nighttime video-EEG-monitoring). EEG changes resembled a 'juvenile' form of epilepsy. At the time of completion of the study, 13 patients were free of seizures and only 5 of 26 patients with DAE did not require treatment with antiepileptic drugs. In patients with Jeavons (n=14) and Tassinari (n=1) syndromes, the disease did not change over time. CONCLUSION: The pathomorphosis of IGE with childhood onset depends on the certain epileptic syndrome.


Assuntos
Epilepsia Tipo Ausência , Epilepsia Generalizada , Epilepsia Mioclônica Juvenil , Adolescente , Adulto , Criança , Eletroencefalografia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/tratamento farmacológico , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/tratamento farmacológico , Humanos , Epilepsia Mioclônica Juvenil/diagnóstico , Epilepsia Mioclônica Juvenil/tratamento farmacológico , Convulsões
3.
Epileptic Disord ; 21(3): 244-251, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31225802

RESUMO

To investigate ictal cerebral haemodynamic characteristics during spontaneous typical absence seizures (TAS) and hyperventilation-evoked absence seizures in paediatric patients, relative to brief complex partial seizures (BCPS). All children diagnosed with seizures using real-time transcranial doppler ultrasonography (TCD) and sleep-deprived video-EEG (vEEG) from 2015 to 2017 in our hospital were included. The seizures were diagnosed based on the video and EEG findings. Mean cerebral blood flow velocity (CBFVm) of the unilateral middle cerebral artery was measured using TCD. TCD and vEEG data were integrated for a synchronous assessment of CBFVm changes and epileptic status. Baseline and peak CBFVm for TAS and BCPS were compared by T-test. Six children (two boys and four girls) with TAS and two girls with BCPS were enrolled. A total of 15 spontaneous TAS, 14 hyperventilation-evoked absence seizures, and six BCPS were recorded using real-time TCD-vEEG monitoring. During spontaneous TAS, whether awake or asleep, the CBFVm decreased by 20-40% compared to baseline. During hyperventilation-evoked absence seizures and BCPS, the CBFVm increased by 50-150% and 20-30% over baseline levels, respectively. The haemodynamic characteristics during TAS and BCPS are distinct, and thus our results may provide a new method to diagnose typical absence seizures using dynamic CBFVm curves. Ictal cerebral haemodynamic characteristics during spontaneous typical absence seizures and hyperventilation-evoked absence seizures may reflect different pathophysiological mechanisms and networks compared with BCPS.


Assuntos
Conscientização/fisiologia , Encéfalo/fisiopatologia , Epilepsia Tipo Ausência/fisiopatologia , Hemodinâmica/fisiologia , Convulsões/fisiopatologia , Encéfalo/irrigação sanguínea , Criança , Eletroencefalografia/métodos , Epilepsia Tipo Ausência/diagnóstico , Feminino , Humanos , Masculino , Convulsões/diagnóstico , Ultrassonografia Doppler Transcraniana , Vigília/fisiologia
4.
Pediatr Dermatol ; 36(4): e99-e101, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31132165

RESUMO

Lymphadenopathy is a common sign for drug reaction and eosinophilia with systemic symptoms (DRESS) syndrome, but hilar and mediastinal lymphadenopathy may be underreported. We describe a 7-year-old boy who started taking ethosuximide for absence seizures and presented with diffuse rash, fever, elevated transaminases, facial swelling, and hilar and mediastinal lymphadenopathy. His mediastinal lymphadenopathy was concerning for lymphoma, which led to more invasive testing to rule out malignancy. This report highlights an unusual and likely underreported presenting sign of DRESS syndrome in children.


Assuntos
Corticosteroides/uso terapêutico , Síndrome de Hipersensibilidade a Medicamentos/etiologia , Epilepsia Tipo Ausência/tratamento farmacológico , Etossuximida/efeitos adversos , Linfadenopatia/induzido quimicamente , Biópsia por Agulha , Criança , Síndrome de Hipersensibilidade a Medicamentos/tratamento farmacológico , Síndrome de Hipersensibilidade a Medicamentos/patologia , Eosinofilia/induzido quimicamente , Eosinofilia/fisiopatologia , Epilepsia Tipo Ausência/diagnóstico , Etossuximida/uso terapêutico , Seguimentos , Humanos , Imuno-Histoquímica , Linfadenopatia/patologia , Linfadenopatia/fisiopatologia , Masculino , Mediastino/patologia , Recidiva , Medição de Risco
6.
Seizure ; 69: 118-124, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31015102

RESUMO

PURPOSE: Eyelid myoclonia with absences (EMA) is an epileptic syndrome characterized by eyelid myoclonia with or without absences, eyes closure-induced EEG paroxysms and photosensitivity. Pathophysiological mechanisms of visual sensitivity in EMA are not-fully understood. The objective of the present study was to analyze the electrophysiological dynamics implicated in the visual sensitivity in patients with EMA. METHODS: We analyzed data of 10 subjects with diagnosis of EMA and of 10 healthy control subjects. For both patients and controls, 4-seconds artifacts-free electroencephalographic signal epochs recorded were analyzed, during resting state, eyes-opened and eyes-closed tasks. Resting state networks in EEG have been computed using independent components analysis (ICA) LORETA. Moreover, the power law exponent ß was obtained for each coordinate as minus the slope of the power spectrum versus frequency in a Log-Log scale. RESULTS: Using LORETA ICA, patients during resting state showed significant differences as compared to controls with a reduction of the physiological alpha activity over the occipital lobe and of the physiological beta activity over the frontal lobe. Immediately after eye closure, a significant increase of beta activity over the frontal lobe was found in the group of patients compared to controls. Power law exponent ß analysis showed a significant increase of ß over the frontal regions in patients as compared to controls during resting-state and an increase of ß over the parieto-occipital regions after eye closure. CONCLUSION: Abnormal occipital and frontal cortex activities seem to be related with the visual sensitivity and eyelid myoclonia observed in patients with EMA.


Assuntos
Eletroencefalografia , Epilepsia Tipo Ausência/fisiopatologia , Pálpebras/fisiopatologia , Mioclonia/fisiopatologia , Eletroencefalografia/métodos , Epilepsias Mioclônicas/diagnóstico , Epilepsias Mioclônicas/fisiopatologia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/fisiopatologia , Epilepsia Reflexa/diagnóstico , Epilepsia Reflexa/fisiopatologia , Lobo Frontal/fisiopatologia , Humanos , Mioclonia/diagnóstico , Lobo Occipital/fisiopatologia
7.
Neurol Sci ; 40(5): 993-1000, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30756246

RESUMO

Localizing the source of epileptiform discharges in generalized epilepsy has been controversial for the past few decades. Recent neuroimaging studies have shown that epileptiform discharges in generalized epilepsy can be localized to a particular region. Childhood absence epilepsy (CAE) is the most common generalized epilepsy in childhood and is considered the prototype of idiopathic generalized epilepsy (IGE). To better understand electrophysiological changes and their development in CAE, we investigated the origin of epileptiform discharges. We performed distributed source localization with standardized, low-resolution, brain electromagnetic tomography (sLORETA). In 16 children with CAE, sLORETA images corresponding to the midpoint of the ascending phase and the negative peak of the spike were obtained from a total of 242 EEG epochs (121 epochs at each timepoint). Maximal current source density (CSD) was mostly located in the frontal lobe (69.4%). At the gyral level, maximal CSD was most commonly in the superior frontal gyrus (39.3%) followed by the middle frontal gyrus (14.0%) and medial frontal gyrus (8.7%). At the hemisphere level, maximal CSD was dominant in the right cerebral hemisphere (63.6%). These results were consistent at the midpoint of the ascending phase and the negative peak of the spike. Our results demonstrated that the major source of epileptiform discharges in CAE was the frontal lobe. These results suggest that the frontal lobe is involved in generating CAE. This finding is consistent with recent studies that have suggested selective cortical involvement, especially in the frontal regions, in IGE.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiopatologia , Eletroencefalografia/métodos , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/fisiopatologia , Criança , Feminino , Humanos , Masculino , Modelos Teóricos , Processamento de Sinais Assistido por Computador
8.
Paediatr Drugs ; 21(1): 15-24, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30734897

RESUMO

Childhood absence epilepsy (CAE) is a common pediatric epilepsy syndrome with distinct seizure semiology, electroencephalography (EEG) features, and treatment. A diagnosis of CAE can be obtained during an office visit with a careful history, physical exam including prolonged hyperventilation, and a routine EEG. The treatment of choice for CAE with absence seizures only is ethosuximide. Valproic acid and lamotrigine are also effective treatments for many patients, but when compared to ethosuximide, valproic acid has more adverse effects and lamotrigine is less effective. Attention to predictors of response to treatment, including clinical, electrographic, and genetic factors, is increasing. Refractory CAE occurs in fewer than half of patients, and treatment strategies are available, though efficacy data are lacking. Careful assessment and treatment of psychosocial comorbidities is essential in caring for patients with CAE.


Assuntos
Epilepsia Tipo Ausência/tratamento farmacológico , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eletroencefalografia , Epilepsia Tipo Ausência/diagnóstico , Etossuximida/uso terapêutico , Feminino , Humanos , Lamotrigina/uso terapêutico , Masculino , Guias de Prática Clínica como Assunto , Convulsões/tratamento farmacológico , Resultado do Tratamento , Ácido Valproico/uso terapêutico
9.
J Clin Neurophysiol ; 36(1): 36-44, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30394946

RESUMO

PURPOSE: Generalized paroxysmal fast activity (GPFA) is a diffuse, paroxysmal, frontal predominant activity described in patients with generalized epilepsies. Studies specifically focusing on electroclinical features of typical absence seizures in children have not reported any GPFA-like features. We sought to identify GPFA in children with typical absence seizures, study its incidence, characteristic electroclinical features, and effect on their epilepsy. METHODS: We performed a retrospective review of electroencephalograms of children with diagnosis of absence epilepsy. A total of 173 subjects were identified. In subjects with GPFA on their electroencephalograms, GPFA characteristics were collected (i.e., predominant location, duration, amplitude, frequency, provocation factors, and if GPFA was followed by spike-wave discharges). In GPFA-positive subjects, further data sets were collected examining their demographics, duration of epilepsy, and pharmacoresponsiveness to epilepsy. RESULTS: Generalized paroxysmal fast activity was identified in 10 subjects (5.78%) with female to male ratio of 9:1. Median age of subjects was 17 years, and median duration of illness was 9.5 years. Mean maximum GPFA amplitude was 88.3 µV with posterior predominance in 9/10 subjects. Generalized paroxysmal fast activity frequency ranged between 11 and 20 Hz with duration of 1 to 4 seconds. Generalized paroxysmal fast activity was provoked with eye closure, hyperventilation, and photic stimulation. Antiseizure medications had no effect on GPFA, and epilepsy was well controlled in most subjects. CONCLUSIONS: Generalized paroxysmal fast activity is uncommon in children with typical absence seizures and has medium voltage, posterior predominance, and marked female preponderance. Generalized paroxysmal fast activity is seen during both pharmacoresponsive and drug-resistant epilepsy, and is not affected by antiseizure medications. It may serve as an independent marker of lifelong epilepsy.


Assuntos
Encéfalo/fisiopatologia , Eletroencefalografia , Epilepsia Tipo Ausência/fisiopatologia , Convulsões/fisiopatologia , Adolescente , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Epilepsia Resistente a Medicamentos/diagnóstico , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Epilepsia Resistente a Medicamentos/epidemiologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/tratamento farmacológico , Epilepsia Tipo Ausência/epidemiologia , Feminino , Humanos , Incidência , Masculino , Estudos Retrospectivos , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Fatores Sexuais , Adulto Jovem
10.
Neurologia ; 34(4): 224-228, 2019 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28325560

RESUMO

INTRODUCTION: Childhood absence epilepsy (CAE) is considered easily manageable with medication provided that a strict patient classification system is employed. It accounts for 10% of all childhood epilepsy cases starting before the age of 15 and it is most frequent in school-aged girls. The aim of this study is to analyse long-term outcomes of patients diagnosed with CAE according to the Loiseau and Panayiotopoulos criteria and treated during childhood. METHODS: We conducted a retrospective study including 69 patients with CAE who are currently older than 11; data were gathered from medical histories, EEG records, and telephone questionnaires. RESULTS: 52 patients met the Loiseau and Panayiotopoulos criteria. Mean age is now 17.16 years. Female-to-male ratio was 1.65:1; mean age at onset was 6 years and 2 months; mean duration of treatment was 3 years and 9 months. A family history of epilepsy was present in 30.8% of the patients and 7.7% had a personal history of febrile convulsions. Absence seizures were simple in 73.5% of the patients and complex in 26.5%. Response rates to first-line treatment were as follows: valproic acid, 46.3%; and valproic acid plus ethosuximide, 90.9%. The rate of response to second-line therapy (ethosuximide or lamotrigine) was 84.2%; 4% of the patients experienced further seizures after treatment discontinuation, 78.8% achieved seizure remission, and 25% needed psychological and academic support. CONCLUSIONS: Our data show that epileptic patients should be classified according to strict diagnostic criteria since patients with true CAE have an excellent prognosis. The relapse rate was very low in our sample. Despite the favourable prognosis, psychological and academic support is usually necessary.


Assuntos
Epilepsia Tipo Ausência/diagnóstico , Adolescente , Anticonvulsivantes/uso terapêutico , Criança , Progressão da Doença , Epilepsia Tipo Ausência/tratamento farmacológico , Etossuximida/uso terapêutico , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Ácido Valproico/uso terapêutico
11.
Epileptic Disord ; 20(6): 557-561, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30530409

RESUMO

We describe a 68-year-old woman who had typical absence seizures since 14 years of age. The absences were refractory to treatment and persisted into adulthood, with no seizure-free periods until seizure control at 59 years of age. After six years of being seizure-free, she presented with an episode characterized by mental confusion, abnormal behaviour, and amnesia, lasting for several hours. An EEG performed the day after, when the patient had already recovered, was unremarkable. The episode was interpreted as transient global amnesia. After two and three years, respectively, she presented with two analogous episodes lasting >24 hours. An EEG disclosed, on both occasions, subcontinuous generalized spike-and-wave discharges, consistent with absence status epilepticus (AS). The last episode occurred at 68 years of age and was successfully treated with intravenous lorazepam. After one month of follow-up, no further episodes occurred. AS is common in juvenile absence epilepsy, however, our patient showed a rather atypical course, characterized by refractory and persistent absences during adolescence and adulthood, and a tendency for AS to recur with no more absences in later life. Despite the known epilepsy history, AS episodes were initially misdiagnosed. Moreover, EEG recording and subsequent treatment were not performed until the second day of status.


Assuntos
Amnésia Global Transitória/diagnóstico , Epilepsia Tipo Ausência/diagnóstico , Idoso , Amnésia Global Transitória/fisiopatologia , Encéfalo/fisiopatologia , Diagnóstico Diferencial , Eletroencefalografia , Epilepsia Tipo Ausência/fisiopatologia , Feminino , Humanos , Recidiva
12.
Epileptic Disord ; 20(6): 502-507, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30530445

RESUMO

Absence status epilepticus (ASE) is a prolonged generalized absence seizure that usually lasts for hours and can even last for days. The main symptom is the altered content of consciousness while the patient may be alert and partly responsive. We describe the electroclinical features, treatment, and evolution of three paediatric patients with de novo ASE with an excellent response to valproic acid (VPA). Three paediatric patients presented with non-convulsive status epilepticus and an acute confusional state with impaired consciousness and EEG abnormalities compatible with typical ASE, associated with generalized spike-and-wave paroxysms at 2.5-4 Hz, as the first epileptic manifestation at eight, three, and nine years of age, respectively. No significant personal and/or family history was reported. None of the patients had absence seizures or any other type of seizure before the occurrence of the ASE. All of them responded well to VPA and had a benign disease course. Neuroradiological imaging was normal in all patients. These three cases presented with ASE as the first manifestation of their epilepsy; none of them had any other type of seizure before the event or during their follow-up, which was long-term in one. All patients had an excellent response to VPA. Our three cases presented with generalized typical ASE as the first manifestation of their epilepsy. De novo ASE might be considered as a well-defined idiopathic epilepsy syndrome or a variant of an idiopathic generalized epilepsy syndrome, such as a particular type or variant of childhood absence epilepsy.


Assuntos
Encéfalo/fisiopatologia , Epilepsia Tipo Ausência/diagnóstico , Estado Epiléptico/diagnóstico , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Eletroencefalografia , Epilepsia Tipo Ausência/tratamento farmacológico , Epilepsia Tipo Ausência/fisiopatologia , Feminino , Humanos , Lorazepam/uso terapêutico , Masculino , Estado Epiléptico/tratamento farmacológico , Estado Epiléptico/fisiopatologia , Ácido Valproico/uso terapêutico
14.
Sci Rep ; 8(1): 4953, 2018 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-29563579

RESUMO

In this paper, we use a model modified from classic corticothalamic network(CT) to explore the mechanism of absence seizures appearing on specific relay nuclei (SRN) of the thalamus. It is found that typical seizure states appear on SRN through tuning several critical connection strengths in the model. In view of previous experimental and theoretical works which were mainly on epilepsy seizure phenomena appearing on excitatory pyramidal neurons (EPN) of the cortex, this is a novel model to consider the seizure observed on thalamus. In particular, the onset mechanism is different from previous theoretical studies. Inspired by some previous clinical and experimental studies, we employ the external stimuli voltage on EPN and SRN in the network, and observe that the seizure can be well inhibited by tuning the stimulus intensity appropriately. We further explore the effect of the signal transmission delays on seizures, and found that the polyspike phenomenon appears only when the delay is sufficiently large. The experimental data also confirmed our model. Since there is a complex network in the brain and all organizations are interacting closely with each other, the results obtained in this paper provide not only biological insights into the regulatory mechanisms but also a reference for the prevention and treatment of epilepsy in future.


Assuntos
Córtex Cerebral/fisiologia , Epilepsia Tipo Ausência/etiologia , Modelos Neurológicos , Núcleos Talâmicos/fisiologia , Potenciais de Ação/fisiologia , Eletroencefalografia , Epilepsia Tipo Ausência/diagnóstico , Humanos , Vias Neurais/fisiologia , Neurônios/fisiologia , Núcleos Talâmicos/citologia
15.
J Neurol Neurosurg Psychiatry ; 89(6): 603-610, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29348303

RESUMO

OBJECTIVES: Depending on patient age at onset, absence epilepsy is subdivided into childhood and juvenile forms. Absence seizures can occur several times per day (pyknoleptic course) or less frequently than daily (non-pyknoleptic course). Seizures typically terminate before adulthood, but a quarter of patients need ongoing treatment beyond adolescence. Little is known about their long-term seizure and psychosocial outcome. METHODS: Files of 135 outpatients with absence epilepsy (76 females; 123 had additional generalised tonic-clonic seizures) were retrospectively analysed after a median follow-up of 45.4 years (IQR: 31.9-56.2). Eighty-two subjects completed an additional interview. Patients were dichotomised according to age at epilepsy onset (childhood: n=82; juvenile: n=53) and course of absence seizures (pyknoleptic: n=80; non-pyknoleptic: n=55). RESULTS: Among all patients, 53% achieved 5-year terminal seizure remission, 16% without antiepileptic medication. Median age at last seizure was lower in patients with childhood onset of absence epilepsy (37.7 years) versus juvenile onset (44.4 years; P≤0.01). However, rates and duration of terminal seizure remission were similar. Pyknoleptic versus non-pyknoleptic course of absence seizures made no difference for long-term seizure outcome. Multivariate analysis identified only higher age at investigation to be associated with terminal 5-year seizure remission. Regarding aspects of psychosocial outcome, there were no significant differences between the respective subgroups. CONCLUSIONS: These data indicate that if absence epilepsy persists beyond adolescence, long-term seizure and psychosocial outcome do not differ between childhood and juvenile onset or between pyknoleptic and non-pyknoleptic course of absence epilepsy. However, higher patient age increases the chance of terminal seizure remission.


Assuntos
Epilepsia Tipo Ausência/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Remissão Espontânea , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
16.
Epilepsia ; 59(3): 523-529, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29327337

RESUMO

OBJECTIVE: Clinical absences are now classified as "generalized nonmotor (absence) seizures" by the International League Against Epilepsy (ILAE). The aim of this paper is to critically review the concept of absences and to put the accompanying focal and motor symptoms into the context of the emerging pathophysiological knowledge. METHODS: For this narrative review we performed an extensive literature search on the term "absence," and analyzed the plethora of symptoms observed in clinical absences. RESULTS: Arising from the localization and the involved cortical networks, motor symptoms may include bilateral mild eyelid fluttering and mild myoclonic jerks of extremities. These motor symptoms may also occur unilaterally, analogous to a focal motor seizure with Jacksonian march. Furthermore, electroencephalography (EEG) abnormalities may exhibit initial frontal focal spikes and consistent asymmetries. Electroclinical characteristics support the cortical focus theory of absence seizures. Simultaneous EEG/functional magnetic resonance imaging (fMRI) measurements document cortical deactivation and thalamic activation. Cortical deactivation is related to slow waves and disturbances of consciousness of varying degrees. Motor symptoms correspond to the spike component of the 3/s spike-and-wave-discharges. Thalamic activation can be interpreted as a response to overcome cortical deactivation. Furthermore, arousal reaction during drowsiness or sleep triggers spikes in an abnormally excitable cortex. An initial disturbance in arousal mechanisms ("dyshormia") might be responsible for the start of this abnormal sequence. SIGNIFICANCE: The classification as "generalized nonfocal and nonmotor (absence) seizure" does not covey the complex semiology of a patient's clinical events.


Assuntos
Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/fisiopatologia , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/fisiopatologia , Eletroencefalografia/métodos , Humanos
17.
J Clin Neurophysiol ; 35(3): 270-272, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28800038

RESUMO

Subclinical rhythmic discharges of adult (SREDA) is a rare benign EEG variant in adults and is of unknown clinical significance. Its occurrence in children is extremely rare. In review of the literature, it has been described in only four children. We present a case of a 10-year-old female with generalized idiopathic childhood absence epilepsy who is noted to have SREDA in three subsequent EEGs performed across a 25-month span. She had no clinical change with these discharges and it was believed to be a benign variant. Including our patient, three of four children with SREDA presented with generalized epilepsy leading to the conclusion that, although rare, SREDA is more common in children presenting with generalized epilepsy.


Assuntos
Encéfalo/fisiopatologia , Eletroencefalografia , Epilepsia Generalizada/fisiopatologia , Criança , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/fisiopatologia , Epilepsia Generalizada/diagnóstico , Feminino , Humanos
18.
Zh Nevrol Psikhiatr Im S S Korsakova ; 117(9. Vyp. 2): 34-38, 2017.
Artigo em Russo | MEDLINE | ID: mdl-29213036

RESUMO

AIM: To investigate the pathomorphosis of idiopathic generalized epilepsy (IGE) in the aspect of prognosis. MATERIAL AND METHODS: The study involved 1480 patients with epilepsy including 281 patients with IGE. RESULTS AND CONCLUSION: 'Juvenile' forms were diagnosed in 228 patients. Relapse of seizures in anamnesis occurred in 19% out of 105 patients with juvenile myoclonic epilepsy (JME). Remission was achieved in 59.2% out of 76 patients with long-term follow-up. Out of 35 patients with juvenile absence epilepsy (JAE), relapse of seizures in anamnesis occurred in 25.7%. Out of 24 patients with long-term follow-up, remission was achieved in 70.8%. Out of 88 patients with IGE with generalized tonic clonic-seizures, relapse of seizures in anamnesis occurred in 15%. Out of 60 patients with long-term follow-up, remission was achieved in 86.7%. The main features of epilepsy pathomorphosis in all groups of patients were the decrease of informativeness of routine EEG, reduction in the frequency and duration of seizures, occurrence of seizures in the discontinuation of therapy and/or under the influence of provoking factors.


Assuntos
Epilepsia Tipo Ausência , Epilepsia Generalizada , Adolescente , Eletroencefalografia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/tratamento farmacológico , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/tratamento farmacológico , Humanos , Convulsões , Resultado do Tratamento
19.
Epilepsia ; 58(11): 1880-1891, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28949013

RESUMO

OBJECTIVE: The study provides updated information about the distribution of seizures, epilepsies, and etiologies of epilepsy in the general child population, and compares the old and new classification systems from the International League Against Epilepsy (ILAE). METHODS: The study platform was the Norwegian Mother and Child Cohort Study. Cases of epilepsy were identified through registry linkages and sequential parental questionnaires. Epilepsy diagnoses were validated using a standardized protocol, and seizures, epilepsies, and etiologies were classified according to the old (ILAE 1981/1989) and new (ILAE 2017) classifications. Information was collected through medical record reviews and/or parental telephone interviews. RESULTS: The study population included 112,744 children aged 3-13 years at the end of follow-up on December 31, 2012. Of these, there were 606 children with epilepsy (CWE). Distribution of seizure types varied by age of onset. Multiple seizure types were common with early onset. Focal epilepsies were the most common, occurring in 317 per 100,000 children in the study population and in 59% of CWE. Generalized epilepsies were found in 190 per 100,000 (35% of CWE). CWE with onset during the first 2 years of life had an even distribution of focal and generalized epilepsies, whereas focal epilepsies became dominant at later ages of onset. A definite cause of epilepsy had been demonstrated in 33% of CWE. The ILAE 1989 classification allowed for a broad syndrome category in 93% of CWE and a defined epileptic syndrome in 37%. With the ILAE 2017 classification, 41% of CWE had a defined epileptic syndrome and 63% had either a defined syndrome or structural-metabolic etiology. SIGNIFICANCE: The distribution of seizures and epilepsies is strongly dependent on age of onset. Despite diagnostic advances, the causes of epilepsy are still unknown in two-thirds of CWE. The ILAE 2017 classifications allow for a higher precision of diagnoses, but at the expense of leaving more epilepsies classifiable only at the mode of onset level.


Assuntos
Epilepsia Tipo Ausência/classificação , Epilepsia Tipo Ausência/etiologia , Internacionalidade , Vigilância da População , Convulsões/classificação , Convulsões/etiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Epilepsia Tipo Ausência/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Noruega/epidemiologia , Vigilância da População/métodos , Convulsões/diagnóstico , Síndrome
20.
Epilepsy Res ; 136: 123-125, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28829985

RESUMO

We evaluated the long-term prognosis of patients featuring the association of absences and myoclonic epilepsy of infancy. Our cohort consisted of 10 male subjects with mean age at seizure onset of 29 months. Follow-up data included seizure outcome and EEG findings. All individuals received antiepileptic drugs (AEDs) as monotherapy (6 patients) or polytherapy (4 patients) for a mean period of 24 months. Over a 30-60 month evaluation period (mean: 43 months), all patients were seizure-free. Follow-up data after withdrawal of antiepileptic therapy were obtained for a mean period of 22 months. None of the children did develop other age-related epileptic syndrome after AEDs discontinuation. Furthermore, follow-up EEG data after drugs withdrawal were normal and none of the patients showed cognitive impairment. In conclusion, we confirm that absence seizures may occur in association with myoclonic epilepsy of infancy. This condition shows excellent prognosis with either favourable neurologic development and seizure outcome in these children.


Assuntos
Epilepsias Mioclônicas/diagnóstico , Epilepsias Mioclônicas/tratamento farmacológico , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/tratamento farmacológico , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/tratamento farmacológico , Anticonvulsivantes/uso terapêutico , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Pré-Escolar , Eletroencefalografia , Epilepsias Mioclônicas/fisiopatologia , Epilepsia Tipo Ausência/fisiopatologia , Epilepsia Generalizada/fisiopatologia , Seguimentos , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Convulsões/fisiopatologia
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