Seizure Types, Epilepsy Syndromes, Etiology, and Diagnosis

CNS Spectrums ◽  
2001 ◽  
Vol 6 (9) ◽  
pp. 750-755 ◽  
Author(s):  
Jonathan C. Edwards
Keyword(s):  
Classification System ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Conscious State ◽  
Cortical Region ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Metabolic Derangement ◽  
Surgical Evaluation ◽  
Recent Classification

ABSTRACTThe clinical manifestation of epileptic seizures may vary widely from patient to patient, depending on the region of the brain involved. Over the centuries, many seizure classific systems have been used, and the current most widely used classification system is that of the International League Against Epilepsy (ILAE). The ILAE system divides seizures into those of partial onset and those of generalized onset, depending on whether the initial clinical manifestations indicate that one cortical region or both hemispheres are involved at the onset of the seizure. Partial seizures are then divided into simple partial seizures, in which a fully conscious state is retained, or complex partial seizures, in which consciousness is impaired. A more recent classification system based purely on symptom features and signs has been proposed, and this system may provide advantages for localization, and especially for surgical evaluation. Epilepsy is a condition characterized by recurrent unprovoked seizures. Epilepsy may be idiopathic, cryptogenic, or symptomatic. Idiopathic epilepsies are generally genetic, and while man such syndromes have been described, advances in molecular genetics will undoubtedly reveal many more syndromes in near future. Cryptogenic epilepsies are those in which an underlying cause is suspected, but the etiology remains undetected. Epilepsies for which there is an underlying structural cause or major metabolic derangement are considered symptomatic. Common causes and diagnostic evaluation are described in this article.

scholarly journals Etiology of epilepsy a prospective study of 210 cases

1991 ◽  
Vol 49 (3) ◽  
pp. 251-254 ◽  
Author(s):  
Walter Oleschko Arruda
Keyword(s):  
Ct Scan ◽  
Neurological Examination ◽  
Epileptic Seizures ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Blood Tests ◽  
Generalized Seizures ◽  
A Prospective Study ◽  
Csf Examination

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

Seizures with Apnea in Children

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 87-90
Author(s):  
Kazuyoshi Watanabe ◽  
Kimiko Hara ◽  
Susumu Hakamada ◽  
Tamiko Negoro ◽  
Midori Sugiura ◽  
...  
Keyword(s):  
Limbic System ◽  
Epileptic Seizures ◽  
High Amplitude ◽  
The Other ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Sharp Waves ◽  
Fast Waves ◽  
Respiratory Embarrassment ◽  
Epileptic Fits

Five children who had apneic attacks as a manifestation of epileptic seizures are reported. In three children, the apneic attacks were the sole symptom of epileptic fits. The other two children had additional types of seizures. The apneic seizures usually lasted one to two minutes and were characterized by respiratory embarrassment rather than complete arrest. These seizures are usually accompanied by cyanosis which appears early during the course of the attack. Although consciousness seemed to be impaired, this was difficult to assess accurately in infants. The ictal EEGs disclosed paroxysmal discharges of focal onset in all cases, consisting of high amplitude θ-waves, gradually mixed with or replaced by sharp waves or spikes in some and fast waves followed by slower waves in others. These occurred in temporal areas in three patients and in frontal and central areas in one patient each. Interictal EEGs, however, revealed paroxysmal discharges in only one patient. Apneic attacks in these infants are considered to be an integral part of the manifestations of complex partial seizures originating mostly in the limbic system.

Partial Seizures in Children

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 725-731
Author(s):  
Gregory L. Holmes
Keyword(s):  
Facial Expressions ◽  
Clinical Manifestations ◽  
Motor Symptoms ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Drop Attacks ◽  
Clinical Events ◽  
Eeg Recordings ◽  
Eeg Features

Although partial seizures occur frequently in childhood, the clinical and EEG manifestations have not been well described. Clinical and EEG features of 198 partial seizures in 56 children with seizures recorded during videotape monitoring with simultaneous telemetered EEG recordings were analyzed. Simple partial seizures were short in duration and consisted primarily of motor symptoms and were not associated with postictal impairment. Complex partial seizures were longer and could be categorized into four subgroups based on the initial clinical manifestations: staring, automatisms, motor phenomena, and drop attacks. All complex partial seizures were associated with changes in facial expressions, and in 87% of the patients automatic behaviors occurred either initially or at some point during the seizures. Unlike simple partial seizures, complex partial seizures were often associated with postictal symptoms. Although complex partial seizures were variable in manifestations from patient to patient, in children with more than one seizure recorded clinical events were usually stereotyped.

scholarly journals Secondary late-onset Lennox-Gastaut syndrome: a critical view

1984 ◽  
Vol 42 (2) ◽  
pp. 95-104
Author(s):  
Amilton Antunes Barreira ◽  
Michel Pierre Lison
Keyword(s):  
Late Onset ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Psychomotor Development ◽  
Average Period ◽  
Partial Seizures ◽  
Simple Complex ◽  
Early Form ◽  
Eeg Abnormalities ◽  
Interictal Eeg

From a group of 66 patients with the Lennox-Gastaut syndrome, 12 whose manifestations had started after the 6th year of life were selected for study. These patients were observed clinically and electroencephalographically for an average period of 2.5 years. We concluded that the late-onset syndrome can: occur after a long interval between diffuse encephalopathy and the first clinical manifestations, with or without previous alterations in psychomotor development; be associated from the onset with serious mental retardation; exhibit simple, complex and mixed seizures similar to those observed in the early form. These patients can also: suffer complex and mixed epileptic seizures previously unreported; paroxismal interictal EEG abnormalities that overlap those of the early form; and spike-slow wave complexes in the EEG that can be actived by hyperpnea. Our results demonstrate that the incidence of LGS after 6 years of age does not necessarily imply a lower frequency of organic antecedents, or beter neu-ropsychomotor development up to the onset of the syndrome or the presence of a higher rate of nonspecific seizures (generalized or partial seizures, and mainly those with elaborate symptomatolgy). The critical and encephalographic expression of the syndrome, which is secondary and starts after the 6th year of age, may depend at least in part on the age when diffuse encephalopathy started.

scholarly journals Is Prolactin a Clinically Useful Measure of Epilepsy?

2006 ◽  
Vol 6 (3) ◽  
pp. 78-79 ◽  
Author(s):  
Elinor Ben-Menachem
Keyword(s):  
Status Epilepticus ◽  
Elevated Serum ◽  
Epileptic Seizures ◽  
Complex Partial Seizure ◽  
Class Ii ◽  
Serum Prolactin ◽  
Tilt Test ◽  
Neonatal Seizures ◽  
Partial Seizures ◽  
Complex Partial Seizures

Use of Serum Prolactin in Diagnosing Epileptic Seizures: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Chen DK, So YT, Fisher RS Neurology 2005;65(5):668–675 (Review) Objective The purpose of this article is to review the use of serum prolactin assay in epileptic seizure diagnosis. Methods The authors identified relevant studies in multiple databases and reference lists. Studies that met inclusion criteria were summarized and rated for quality of evidence, and the results were analyzed and pooled where appropriate. Results Most studies used a serum prolactin of at least twice baseline value as abnormal. For the differentiation of epileptic seizures from psychogenic nonepileptic seizures, one Class I and seven Class II studies showed that elevated serum prolactin was highly predictive of either generalized tonic–clonic or complex partial seizures. Pooled sensitivity was higher for generalized tonic–clonic seizures (60.0%) than for complex partial seizures (46.1%), while the pooled specificity was similar for both (approximately 96%). Data were insufficient to establish validity for simple partial seizures. Two Class II studies were consistent in showing prolactin elevation after tilt-test–induced syncope. Inconclusive data exist regarding the value of serum prolactin following status epilepticus, repetitive seizures, and neonatal seizures. Recommendations Elevated serum prolactin assay, when measured in the appropriate clinical setting at 10 to 20 minutes after a suspected event, is a useful adjunct for the differentiation of generalized tonic–clonic or complex partial seizure from psychogenic nonepileptic seizure among adults and older children (Level B). Serum prolactin assay does not distinguish epileptic seizures from syncope (Level B). The use of serum PRL assay has not been established in the evaluation of status epilepticus, repetitive seizures, and neonatal seizures (Level U).

scholarly journals A Study On Clinical Profile And Semiology In Complex Partial Seizures And Its Radiological Correlation

2021 ◽  
Author(s):  
Nandini Priyanka Balasubramani ◽  
Elangovan S ◽  
Thangaraj M
Keyword(s):  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Epileptic Seizures ◽  
Complex Partial Seizure ◽  
Febrile Seizures ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Cross Sectional

Background: Epilepsy is the second most common and frequently encountered neurological disorder which poses huge threat to known healthcare systems worldwide also causing financial, socio economic burden to the community. Complex Partial Seizures are a form of focal epileptic seizures that may impair consciousness. Aim and objectives: Our motivation for the study was to understand the extent of patients with complex partial seizures associated with medial temporal lobe sclerosis. Materials and methods: We performed a cross sectional study about patients with complex partial seizures in Thanjavur medical college and hospital about their clinical profile and neuro-radiological correlation. Statistical analysis and results: Through our multimodal study with EEG, MRI on N=118 (female / male, age range, Most common age group- 10-20 years, mean age of 23 years, SD- 14 years, 66% males), we observed that atypical febrile seizures and fever provoked seizures has more association (18%) to complex partial seizures and to medial temporal lobe sclerosis in comparison to 12% in an earlier study. Conclusion: We believe this study summarizes the complex partial seizure features, origin, and their link to Medial Temporal lobe Sclerosis in our subject pool from Thajavur, India. Limitation: There are some limitations to our study, especially with no video EEG monitoring and no invasive EEG recording. We aim to improve them in our future studies.

scholarly journals Transnasal endoscopic removal of hypothalamic hamartoma (case reports)

2019 ◽  
Vol 21 (1) ◽  
pp. 72-82 ◽  
Author(s):  
A. Yu. Grigoriev ◽  
I. S. Trifonov ◽  
M. V. Sinkin ◽  
E. V. Grigorieva ◽  
I. L. Kaimovskiy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Duration ◽  
Epileptic Seizures ◽  
Effective Control ◽  
Resonance Imaging ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Generalized Complex ◽  
The Brain

The study objective is to report 2 cases of endoscopic transsphenoidal removal of hypothalamic hamartomas (HH). This surgical method has not been previously considered in both Russian and foreign publications. Materials and methods. A 16-year-old male patient (R.) was admitted to hospital with complaints of epileptic seizures occurring once every 5–6 days; the disease duration was 9 years. A 23-year-old female patient (M.) was also admitted to hospital with complaints of epileptic seizures occurring once a week; the disease duration was 16 years. Results. Magnetic resonance imaging of the brain of patient R. revealed a HH (1.5 cm × 1.4 cm × 1.4 cm) and focal cortical dysplasia in the right occipital lobe. During a 3-day video electroencephalogram monitoring, we registered 3 secondary generalized complex partial seizures. Patient R. underwent endoscopic transsphenoidal removal of the HH. After surgery, he experienced no epileptic seizures during the next 18 months, even though he continued to receive the same doses of antiepileptic drugs. Magnetic resonance imaging of the brain of patient M. demonstrated a HH (2.44 cm × 2.79 cm × 2.68 cm). During a 4-day video electroencephalogram monitoring, we registered 2 secondary generalized complex partial seizures. The patient underwent transsphenoidal removal of the HH. During the next 8 months, the patient experienced no seizures. Conclusion. Our results suggest that transnasal removal of HH is a highly effective and safe procedure for patients with drug-resistant epilepsy. Surgical removal of HHs ensures effective control of the disease, which was previously resistant to pharmacotherapy.

scholarly journals Prevalence of epilepsy in a case series of multiple sclerosis patients

2010 ◽  
Vol 68 (5) ◽  
pp. 731-736 ◽  
Author(s):  
Cynthia Dumas Viveiros ◽  
Regina Maria Papais Alvarenga
Keyword(s):  
Multiple Sclerosis ◽  
Hippocampal Sclerosis ◽  
Case Series ◽  
Chronic Phase ◽  
Epileptic Seizures ◽  
The Other ◽  
Resonance Imaging ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Multiple Sclerosis Patients

OBJECTIVE: The prevalence of epilepsy in multiple sclerosis (MS) patients has been a subject of interest for some years. The objectives of this study were to describe the clinical, radiological and electroencephalographic characteristics of epileptic seizures and to calculate the prevalence of epilepsy in a case series of MS patients. METHOD: Medical charts of MS patients were reviewed and patients who had suffered epileptic seizures were identified. RESULTS: Of 160 cases analyzed, 5 had suffered epileptic seizures and one had comorbid mesial hippocampal sclerosis, confirmed by magnetic resonance imaging in a patient with complex partial seizures that began fifteen years prior to her diagnosis of MS. In the other four patients, seizures occurred both during the acute phase of the disease and in the chronic phase. CONCLUSION: The prevalence of epileptic seizures in MS patients in this study was 2.5%, similar to that found in other studies.

scholarly journals When epilepsy may have changed history: Antônio Moreira César as the commander of the third expedition in the war of Canudos

2003 ◽  
Vol 61 (2B) ◽  
pp. 503-509 ◽  
Author(s):  
Elza Márcia Targas Yacubian
Keyword(s):  
Epileptic Seizures ◽  
Visual Hallucinations ◽  
Partial Seizures ◽  
Language Deficits ◽  
Complex Partial Seizures ◽  
The Third ◽  
Focal Seizures ◽  
Brazilian History ◽  
Secondary Generalization

Colonel Antônio Moreira César, the Commander of the third Expedition against Canudos (1896-1897), nicknamed "head-chopper", was considered an implacable military man, a synonym of ferocity and extreme brutality against his adversaries. Therefore, he was nominated the Commander of an expedition considered almost invincible. Since his 30's he presented epileptic seizures, which increased in frequency and severity on his way to Canudos. After several well-documented episodes and probably considering himself the winner in anticipation, he ordered a premature and almost ingenuous attack against Canudos. His misjudging is attributed to the effect of successive seizures. He was shot and killed on the very first day of that battle and his expedition had a horrible and unexpected end. Based on the descriptions of his biographer we discuss the nature of his disease probably characterized by focal seizures with elementary and complex visual hallucinations followed by language deficits and episodes of complex partial seizures and secondary generalization and its role in this episode of Brazilian history.

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