scholarly journals Cases with parietal and occipital lobe epilepsies

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Hermann Stefan
Keyword(s):  
Source Localization ◽  
Focal Epilepsy ◽  
Occipital Lobe ◽  
Visual Disturbance ◽  
Epileptic Activity ◽  
Whole Body ◽  
Dark Spot ◽  
Posterior Cortex ◽  
Focal Epileptic Activity ◽  
Clonic Convulsions

Abstract Background For seizures emerging from the posterior cortex it can be a challenge to differentiate if they belong to temporal, parietal or occipital epilepsies. Sensoric auras like visual phenomena may occur in all of these focal epilepsies. Ictal signs may mimic non- epileptic seizures. Case presentations Case 1: Patient suffering from a pharmacoresistent focal epilepsy. Focal seizures with sudden visual disturbance, later during the seizure epigastric aura, vertigo-nausea, involvement to bilateral tonic-clonic seizures. MEG detected interictal spikes, source localization indicated focal epileptic activity parietal right. Case 2: Patient with focal pharmacoresistent epilepsy, semiology with focal unaware seizures, feeling that something like a coat is imposed from behind on him, then feeling cold over the whole body, goose bumbs from both arms to head, then block of motoric activity, later focal unaware seizures with stare gaze, blinking of eyes, clouding of consciousness, elevation of arms and legs, sometimes tonic-clonic convulsions. EEG/MEG source localization and MRI detected an epileptogenic lesion parietal left. Case 3: Patient with pharmacoresistent focal epilepsy, focal aware seizures, a dark spot occurring in the left visual field, sometimes anxiety during seizures (leading to the suspicion of non-epileptic psychogenic pseudo seizures). MRI demonstrated an atrophy occipito-temporal right after sinus vein thrombosis. Ictal video-EEG showed a focal seizure onset occipital right. Conclusion Contribution of noninvasive and/or invasive confirmation of the localization of the underlying focal epileptic activity in posterior cortex is illustrated. Characteristics of posterior cortex epilepsies are ventilated.

scholarly journals SPECT Measurements with 99mTc-HM-PAO in Focal Epilepsy

1988 ◽  
Vol 8 (1_suppl) ◽  
pp. S95-S100 ◽  
Author(s):  
Erik Ryding ◽  
Ingmar Rosén ◽  
Dan Elmqvist ◽  
David H. Ingvar
Keyword(s):  
Focal Epilepsy ◽  
Epileptic Activity ◽  
Epileptic Focus ◽  
Focal Epileptic Activity ◽  
Interictal Eeg ◽  
Neurosurgical Treatment

The ability of SPECT measurements with [99mTc]–HM-PAO (Ceretec) to find the location of the epileptic focus was studied in patients under consideration for neurosurgical treatment for therapy-resistant focal epilepsy. The location of low [99mTc]–HM-PAO uptake regions found at interictal measurements, and of high [99mTc]–HM-PAO uptake regions found at ictal measurements, was compared to the findings of extensive ictal and interictal EEG examinations, and to the results of CT and MRT. While EEG revealed focal epileptic activity in all of the 14 patients, SPECT showed regional abnormalities in 13 (93%). CT and MRT showed abnormal findings in 30%.

scholarly journals Detection of epileptic activity in presumably normal EEG

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Sara Baldini ◽  
Francesca Pittau ◽  
Gwenael Birot ◽  
Vincent Rochas ◽  
Miralena I Tomescu ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Epileptic Activity ◽  
Scalp Eeg ◽  
Vigilance State ◽  
Explained Variance ◽  
Long Term Monitoring ◽  
Interictal Discharges ◽  
The Individual ◽  
Term Monitoring

Abstract Monitoring epileptic activity in the absence of interictal discharges is a major need given the well-established lack of reliability of patients’ reports of their seizures. Up to now, there are no other tools than reviewing the seizure diary; however, seizures may not be remembered or dismissed voluntarily. In the present study, we set out to determine if EEG voltage maps of epileptogenic activity in individual patients can help to identify disease activity, even if their scalp EEG appears normal. Twenty-five patients with pharmacoresistant focal epilepsy were included. For each patient, 6 min of EEG with spikes (yes-spike) and without visually detectable epileptogenic discharges (no-spike) were selected from long-term monitoring recordings (EEG 31–37 channels). For each patient, we identified typical discharges, calculated their average and the corresponding scalp voltage map (‘spike-map’). We then fitted the spike-map for each patient on their (i) EEG epochs with visible spikes, (ii) epochs without any visible spike and (iii) EEGs of 48 controls. The global explained variance was used to estimate the presence of the spike-maps. The individual spike-map occurred more often in the spike-free EEGs of patients compared to EEGs of healthy controls (P = 0.001). Not surprisingly, this difference was higher if the EEGs contained spikes (P < 0.001). In patients, spike-maps were more frequent per second (P < 0.001) but with a shorter mean duration (P < 0.001) than in controls, for both no-spike and yes-spike EEGs. The amount of spike-maps was unrelated to clinical variables, like epilepsy severity, drug load or vigilance state. Voltage maps of spike activity are present very frequently in the scalp EEG of patients, even in presumably normal EEG. We conclude that spike-maps are a robust and potentially powerful marker to monitor subtle epileptogenic activity.

scholarly journals With or without spikes: localization of focal epileptic activity by simultaneous electroencephalography and functional magnetic resonance imaging

Brain ◽  
2011 ◽  
Vol 134 (10) ◽  
pp. 2867-2886 ◽  
Author(s):  
Frédéric Grouiller ◽  
Rachel C. Thornton ◽  
Kristina Groening ◽  
Laurent Spinelli ◽  
John S. Duncan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Epileptic Activity ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Focal Epileptic Activity

Sleep Disorder: An Overlooked Manifestation of Glucose Transporter Type-1 Deficiency Syndrome

2021 ◽  
Author(s):  
Kingthong Anurat ◽  
Chaiyos Khongkhatithum ◽  
Thipwimol Tim-Aroon ◽  
Chanin Limwongse ◽  
Lunliya Thampratankul
Keyword(s):  
Sleep Disorder ◽  
Developmental Delay ◽  
Daytime Sleepiness ◽  
Glucose Transporter ◽  
Focal Epilepsy ◽  
Deficiency Syndrome ◽  
Clinical Findings ◽  
Whole Body ◽  
Global Developmental Delay

AbstractGlucose transporter type-1 deficiency syndrome (Glut1 DS) is a rare disorder with various manifestations. Early diagnosis is crucial because treatment with the ketogenic diet can lead to clinical improvement. Here, we report the cases of two siblings with Glut1 DS and one of them presented with sleep disorder which is a rare and atypical manifestation of Glut1 DS. Patient 1 was a 3.5-year-old boy who presented with paroxysmal loss of tone and weakness of the whole body with unresponsiveness after waking up. He also had excessive daytime sleepiness, insomnia, and restless sleep. His other clinical findings included focal seizures, paroxysmal exercise-induced dyskinesia (PED), ataxia, mild global developmental delay, and hyperactivity. Patient 2 was a 5.5-year-old boy who presented with drug-resistant focal epilepsy, global developmental delay, paroxysmal dystonia, and ataxia. A novel heterozygous nonsense variant of SLC2A1, c.1177G > T (p.Glu393*), classified as a pathogenic variant, was identified in both patients, but not in their parents' blood. After treatment with the modified Atkins diet, their neurological functions significantly improved. In conclusion, we reported two siblings with variable phenotypes of Glut1 DS with a novel nonsense mutation. Although sleep disorder and daytime somnolence were the nonclassical manifestations of Glut1 DS, the diagnostic evaluation of possible Glut1 DS in patients presented with daytime sleepiness, particularly in cases with the cooccurrence of seizures or movement disorders should be considered.

scholarly journals Investigation of Cerebral O-(2-[18F]Fluoroethyl)-L-Tyrosine Uptake in Rat Epilepsy Models

2020 ◽  
Vol 22 (5) ◽  
pp. 1255-1265
Author(s):  
Carina Stegmayr ◽  
Rainer Surges ◽  
Chang-Hoon Choi ◽  
Nicole Burda ◽  
Gabriele Stoffels ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Focal Epilepsy ◽  
Epileptic Seizures ◽  
Brain Regions ◽  
Epileptic Activity ◽  
Fet Pet ◽  
Tumor Diagnostics ◽  
Potential Marker ◽  
Epilepsy Models ◽  
Class Iv

Abstract Purpose A recent study reported on high, longer lasting and finally reversible cerebral uptake of O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) induced by epileptic activity. Therefore, we examined cerebral [18F]FET uptake in two chemically induced rat epilepsy models and in patients with focal epilepsy to further investigate whether this phenomenon represents a major pitfall in brain tumor diagnostics and whether [18F]FET may be a potential marker to localize epileptic foci. Procedures Five rats underwent kainic acid titration to exhibit 3 to 3.5 h of class IV–V motor seizures (status epilepticus, SE). Rats underwent 4× [18F]FET PET and 4× MRI on the following 25 days. Six rats underwent kindling with pentylenetetrazol (PTZ) 3 to 8×/week over 10 weeks, and hence, seizures increased from class I to class IV. [18F]FET PET and MRI were performed regularly on days with and without seizures. Four rats served as healthy controls. Additionally, five patients with focal epilepsy underwent [18F]FET PET within 12 days after the last documented seizure. Results No abnormalities in [18F]FET PET or MRI were detected in the kindling model. The SE model showed significantly decreased [18F]FET uptake 3 days after SE in all examined brain regions, and especially in the amygdala region, which normalized within 2 weeks. Corresponding signal alterations in T2-weighted MRI were noted in the amygdala and hippocampus, which recovered 24 days post-SE. No abnormality of cerebral [18F]FET uptake was noted in the epilepsy patients. Conclusions There was no evidence for increased cerebral [18F]FET uptake after epileptic seizures neither in the rat models nor in patients. The SE model even showed decreased [18F]FET uptake throughout the brain. We conclude that epileptic seizures per se do not cause a longer lasting increased [18F]FET accumulation and are unlikely to be a major cause of pitfall for brain tumor diagnostics.

Beyond the Epileptic Focus: Functional Epileptic Networks in Focal Epilepsy

2019 ◽  
Vol 30 (4) ◽  
pp. 2338-2357 ◽  
Author(s):  
Francisco Gil ◽  
Nelly Padilla ◽  
Sara Soria-Pastor ◽  
Xavier Setoain ◽  
Teresa Boget ◽  
...  
Keyword(s):  
Independent Component Analysis ◽  
Focal Epilepsy ◽  
Component Analysis ◽  
Epileptic Activity ◽  
Independent Component ◽  
Electrode Placement ◽  
Functional Architecture ◽  
Brain Areas ◽  
Time Courses ◽  
Epileptic Networks

Abstract Focal epilepsy can be conceptualized as a network disorder, and the functional epileptic network can be described as a complex system of multiple brain areas that interact dynamically to generate epileptic activity. However, we still do not fully understand the functional architecture of epileptic networks. We studied a cohort of 21 patients with extratemporal focal epilepsy. We used independent component analysis of functional magnetic resonance imaging (fMRI) data. In order to identify the epilepsy-related components, we examined the general linear model-derived electroencephalography-fMRI (EEG–fMRI) time courses associated with interictal epileptic activity as intrinsic hemodynamic epileptic biomarkers. Independent component analysis revealed components related to the epileptic time courses in all 21 patients. Each epilepsy-related component described a network of spatially distributed brain areas that corresponded to the specific epileptic network in each patient. We also provided evidence for the interaction between the epileptic activity generated at the epileptic network and the physiological resting state networks. Our findings suggest that independent component analysis, guided by EEG–fMRI epileptic time courses, have the potential to define the functional architecture of the epileptic network in a noninvasive way. These data could be useful in planning invasive EEG electrode placement, guiding surgical resections, and more effective therapeutic interventions.

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