scholarly journals Frontal lobe epilepsy manifesting as vertigo: a case report and literature review

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052094616
Author(s):  
Yongning Jiang ◽  
Xiangqin Zhou
Keyword(s):  
Frontal Lobe ◽  
Cortical Neurons ◽  
Relevant Literature ◽  
Frontal Lobe Epilepsy ◽  
Epileptiform Discharges ◽  
History Of ◽  
Clonic Seizures ◽  
Wave Complex ◽  
Oral Sodium

Frontal lobe epilepsy is a common neurological disorder with a broad spectrum of symptoms. Frontal lobe epilepsy presenting with vertigo is extremely rare, and the relevant pathogenesis remains unclear. Herein, we report a case of frontal lobe epilepsy manifesting as vertigo, and we review the relevant literature. A 34-year-old woman presented with a 10-year history of general tonic–clonic seizures. In the month prior to admission, she experienced nocturnal seizures on two occasions. Video electroencephalogram monitoring showed frequent clinical seizures during which the patient felt transient vertigo. The ictal electroencephalogram revealed a medium-amplitude spike and slow wave complex originating from the frontal lobes. The patient was treated with oral sodium valproate, levetiracetam, and lamotrigine. After a 6-month follow-up period, her seizures were well controlled. Our findings expand the symptom spectrum of epilepsy, suggesting that vertigo can be an uncommon clinical manifestation of frontal lobe epilepsy. Although the pathological correlation between vertigo and epilepsy remains elusive, our findings indicate that vestibular cortical neurons may participate in periodic epileptiform discharges of the frontal lobe. Clinicians should be aware of a potential diagnosis of epilepsy in patients presenting with vertigo as the onset symptom because this condition is usually underdiagnosed.

scholarly journals Mirror writing in a patient with frontal-lobe epilepsy

2021 ◽  
Author(s):  
Vityala Yethindra ◽  
Elmira Mamytova ◽  
Tugolbai Tagaev ◽  
Sagynali Mamatov
Keyword(s):  
Intensive Care Unit ◽  
Frontal Lobe ◽  
Refractory Status Epilepticus ◽  
Frontal Lobe Epilepsy ◽  
Impaired Consciousness ◽  
Refractory Status ◽  
History Of ◽  
Clonic Seizures ◽  
The Right ◽  
Mirror Writing

A 36-year-old male with non-lesional refractory frontal-lobe epilepsy, diagnosed at 16 years of age, and with a history of four hospitalizations for refractory status epilepticus and admitted to the intensive care unit with focal seizures in the right upper limb, impaired consciousness, and recurrent progression to bilateral tonic-clonic seizures.

Ring Chromosome 20 with Nonconvulsive Status Epilepticus: Electroclinical Correlation of a Rare Epileptic Syndrome

2005 ◽  
Vol 36 (3) ◽  
pp. 151-160 ◽  
Author(s):  
Chaichon Locharernkul ◽  
Alois Ebner ◽  
Chinvorn Promchainant
Keyword(s):  
Status Epilepticus ◽  
Ring Chromosome ◽  
Nonconvulsive Status Epilepticus ◽  
Complex Partial Seizures ◽  
Thai Women ◽  
Verbal Stimuli ◽  
Chromosome 20 ◽  
History Of ◽  
Clonic Seizures

The electroclinical features of two Thai women with ring chromosome 20 and nonconvulsive status epilepticus (NCSE) were studied. Both have also had generalized tonic-clonic seizures and complex partial seizures of varying frequencies since adolescence. Their intellectual functions were normal. Twenty-four-hour video/EEG telemetry recorded during the NCSE showed fluctuating consciousness between overt unresponsiveness and normal awareness. The EEG consisted of long-lasting generalized rhythmic 3–5 Hz sharp or slow waves with a few spikes, lasting several days. Despite the continuous discharges, the patients had relatively subtle clinical episodes of seizures, during which they were sometimes responsive to verbal stimuli. Intravenous antiepileptic drugs (AED) had little effect on the rhythmic EEG. No lesion in their MRIs contributed to NCSE. Ring chromosome 20 was found in 20% of female karyotype in both patients [46,XX, r(20) (p13 q13)/46,XX] but were negative in four healthy siblings. Oral AEDs decreased more than 75% of the overt CPS episodes in both patients at 22 and 26 months of follow-up but had no effect on the natural history of electrical NCSE. The patients' daily activities were minimally affected by the ongoing electrical discharges. These are the first two cases reported of ring chromosome 20 with NCSE in Thailand. Our patients present a rather benign and pharmacologically responsive course probably because of the low percentage of r(20) mosaicism. The electroclinical correlations in our cases raise the possibility that the mechanism of continuous rhythmic waves in this syndrome may be unrelated to epilepsy. Assessing the severity of this syndrome using both clinical seizures and EEG is crucial.

scholarly journals A novel KCNT1 mutation in a Chinese family with severe autosomal-dominant nocturnal frontal lobe epilepsy

2021 ◽  
Vol 12 (1) ◽  
pp. 330-334
Author(s):  
Na Xie ◽  
Weiwei Qin ◽  
Jianzhong Deng ◽  
Jinxing Qi ◽  
Dewang Niu ◽  
...  
Keyword(s):  
Potassium Channel ◽  
Frontal Lobe ◽  
Autosomal Dominant ◽  
Psychiatric Symptoms ◽  
Chinese Family ◽  
Frontal Lobe Epilepsy ◽  
Nocturnal Frontal Lobe Epilepsy ◽  
History Of ◽  
Suicidal Thoughts And Behaviors ◽  
Psychiatric Problems

Abstract We describe a Chinese family with severe autosomal-dominant nocturnal frontal lobe epilepsy (ADNFLE) and psychiatric problems in whom whole-exome family trio sequencing identified a heterozygous mutation in the potassium channel subfamily T, member 1 (KCNT1), a sodium-gated potassium channel gene, which was a novel missense mutation c.2153A>T (p. Asp718Val). The typical characteristics of the three patients in the family were refractory epilepsy, acquired cognitive impairment, and psychiatric problems, which include hallucinations and suicidal thoughts and behaviors. The age at onset was found to be earlier in son and daughter of the proband than that of the proband, as proven by the proband’s history of an epileptic seizure at the age of 16 years and her son’s and daughter’s history of seizures at the age of 8 years. Magnetic resonance imaging findings were negative for any abnormalities. Because of psychiatric symptoms, these three patients were administered risperidone at different times during their illness. The protestor’s son had tried fenofibrate treatment, but clinical remission was unclear. In summary, our findings broadened the mutation database in relation to KCNT1 and implicated the sodium-gated potassium channel complex in ADNFLE, more broadly, in the pathogenesis of focal epilepsies.

scholarly journals Preoperative Electroencephalographic Localization of Large Epileptogenic Zones in the Frontal and Temporal Lobes

1991 ◽  
Vol 18 (S4) ◽  
pp. 564-565 ◽  
Author(s):  
Cosimo Ajmone-Marsan
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Frontal Lobe ◽  
Temporal Lobe ◽  
Cortical Neurons ◽  
Frontal Lobe Epilepsy ◽  
Epileptogenic Zone ◽  
Large Area ◽  
Temporal Lobes ◽  
Concentric Circles

ABSTRACT:The concept of epileptogenic zone is defined as a large area of cortical neurons arranged in concentric circles of variable degrees of epileptogenicity. This is particularly so in frontal lobe epilepsy since the interictal and ictal epileptic abnormalities are poorly localized, often absent and at times misleading in terms of localization. In temporal lobe epilepsy, the epileptogenic zones may be more restricted.

Epileptiform Activity in Electroencephalogram of Normal Children

2017 ◽  
Vol 48 (05) ◽  
pp. 356-362
Author(s):  
Azza Alshahawy ◽  
Walid El-Shehaby ◽  
Amira Darwish
Keyword(s):  
Epileptiform Activity ◽  
Psychological Disorder ◽  
Normal Children ◽  
Unprovoked Seizure ◽  
Seizure Disorders ◽  
Epileptiform Discharges ◽  
Egyptian Children ◽  
History Of ◽  
History Of Epilepsy

Objectives This prospective cohort study assessed the prevalence of epileptiform discharges (EDs) in a cohort of healthy Egyptian children aged 1 to 18 years. Methods Children with a history of unprovoked seizure disorders, family history of epilepsy, neurological or psychological disorder, or any other chronic illness were excluded. Digital electroencephalogram (EEG) was recorded under resting condition for a minimum of 20 minutes including activation methods. Results The study included 1,382 healthy Egyptian children with no history of unprovoked seizures. Twenty-nine normal children had EDs, which represents 2.1% of total number of studied children. Centrotemporal spikes were detected in 19 children. The prevalence of EDs was significantly higher in children aged 6 to 12 years (3.59%) compared with children aged 13 to 18 years (1.2%) and children aged 1 to 5 years (0.45%). Conclusions EDs can be observed in nonepileptic normal children. Centrotemporal spikes are the most common epileptiform pattern in EEG of normal children. None of normal children with EDs developed seizures or other neurological disorders during follow-up.

Episodic nocturnal wandering in a patient with epilepsy due to a right temporoinsular low-grade glioma: relief following resection

2006 ◽  
Vol 104 (3) ◽  
pp. 436-439 ◽  
Author(s):  
Hugues Duffau ◽  
Michèle Kujas ◽  
Luc Taillandier
Keyword(s):  
Frontal Lobe ◽  
Antiepileptic Drugs ◽  
Tumor Resection ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Atypical Form ◽  
Patient Reported ◽  
History Of ◽  
Unusual Type

✓ Although controversial, episodic nocturnal wandering (ENW) is thought to be a rare and atypical form of nocturnal epilepsy, originating in the frontal lobe and responsive to antiepileptic drugs (AEDs). The authors report the case of a patient harboring a right temporoinsular low-grade glioma, who presented with a 3-year history of agitated somnambulent episodes resistant to AEDs. Interestingly, the ENW totally resolved after tumor resection and the patient reported no recurrence during a follow-up period of 4.5 years. To the authors’ knowledge, this is the first report of ENW due to a glioma; the findings support the theory that ENW may represent an unusual type of lesional epilepsy that is surgically correctable. Moreover, a temporoinsular origin of ENW can now be considered.

scholarly journals Predictive Factors of Surgical Outcome in Frontal Lobe Epilepsy Explored with Stereoelectroencephalography

Neurosurgery ◽  
2017 ◽  
Vol 83 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Francesca Bonini ◽  
Aileen McGonigal ◽  
Didier Scavarda ◽  
Romain Carron ◽  
Jean Régis ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Surgical Resection ◽  
Complete Resection ◽  
Conditional Inference ◽  
Prognostic Indicators ◽  
Frontal Lobe Epilepsy ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Epileptogenic Zone

Abstract BACKGROUND Resective surgery established treatment for pharmacoresistant frontal lobe epilepsy (FLE), but seizure outcome and prognostic indicators are poorly characterized and vary between studies. OBJECTIVE To study long-term seizure outcome and identify prognostic factors. METHODS We retrospectively analyzed 42 FLE patients having undergone surgical resection, mostly preceded by invasive recordings with stereoelectroencephalography (SEEG). Postsurgical outcome up to 10-yr follow-up and prognostic indicators were analyzed using Kaplan–Meier analysis and multivariate and conditional inference procedures. RESULTS At the time of last follow-up, 57.1% of patients were seizure-free. The estimated chance of seizure freedom was 67% (95% confidence interval [CI]: 54-83) at 6 mo, 59% (95% CI: 46-76) at 1 yr, 53% (95% CI: 40-71) at 2 yr, and 46% (95% CI: 32-66) at 5 yr. Most relapses (83%) occurred within the first 12 mo. Multivariate analysis showed that completeness of resection of the epileptogenic zone (EZ) as defined by SEEG was the main predictor of seizure outcome. According to conditional inference trees, in patients with complete resection of the EZ, focal cortical dysplasia as etiology and focal EZ were positive prognostic indicators. No difference in outcome was found in patients with positive vs negative magnetic resonance imaging. CONCLUSION Surgical resection in drug-resistant FLE can be a successful therapeutic approach, even in the absence of neuroradiologically visible lesions. SEEG may be highly useful in both nonlesional and lesional FLE cases, because complete resection of the EZ as defined by SEEG is associated with better prognosis.

Neuropsychological performance following a history of multiple self-reported concussions: A meta-analysis

2009 ◽  
Vol 16 (2) ◽  
pp. 262-267 ◽  
Author(s):  
HEATHER G. BELANGER ◽  
ERIC SPIEGEL ◽  
RODNEY D. VANDERPLOEG
Keyword(s):  
Brain Injuries ◽  
Neuropsychological Functioning ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Cognitive Domains ◽  
History Of ◽  
The Impact ◽  
Symptom Complaints

AbstractDebate continues about the long-term neuropsychological impact of multiple mild traumatic brain injuries (MTBI). A meta-analysis of the relevant literature was conducted to determine the impact of having a history of more than one self-reported MTBI (versus just one MTBI) across seven cognitive domains, as well as symptom complaints. The analysis was based on 8 studies, all conducted with athletes, involving 614 cases of multiple MTBI and 926 control cases of a single MTBI. The overall effect of multiple MTBI on neuropsychological functioning was minimal and not significant (d = 0.06). However, follow-up analyses revealed that multiple self-reported MTBI was associated with poorer performance on measures of delayed memory and executive functioning. The implications and limitations of these findings are discussed. (JINS, 2010, 16, 262–267.)

scholarly journals Morphological Description of Frontal EEG Interictal and Ictal Discharges in an Adult Cohort of 175 Patients

2021 ◽  
Vol 10 (6) ◽  
pp. 1219
Author(s):  
Beatriz García-López ◽  
María Sueiras-Gil ◽  
Ana Isabel Gómez-Menéndez ◽  
Fernando Vázquez-Sánchez ◽  
María Carmen Lloria-Gil ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Epileptic Seizures ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Clinical Event ◽  
Morphological Description ◽  
Frontal Lobe Epilepsy ◽  
Cross Sectional ◽  
Sharp Waves ◽  
Epileptiform Discharges

Clinical and electroencephalogram (EEG) features in frontal lobe epilepsy (FLE) vary considerably among patients, making the diagnosis a challenge. The objective of this study was to describe interictal and ictal EEG activity, identifying variables that could help to differentiate and diagnose frontal lobe epilepsy cases. A prospective cross-sectional study from patients with frontal interictal epileptiform discharges (IED) referred to the Vall d’Hebron University Hospital (Barcelona, Spain) after a clinical event compatible with epileptic seizures was designed. The interictal and ictal activity were analyzed to provide a detailed EEG description of the cases, using different statistical analyses. The morphological seizure pattern at the ictal onset remained globally unchanged over time in seizures arising from the frontal lobe for each patient. Isolated sharp waves were the most frequent waveforms in the expression of IED. Frontal lobe seizures are frequently short and sometimes appear grouped in clusters within the same recording. Often the ictal expression of the electrical activity in frontal lobe seizure is subtle and challenging to interpret. A description of the main findings is summarized to identify seizures arising from the frontal lobe and avoid false negatives findings in EEG interpretations.

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