Syndromic classification of patients with typical absence seizures

The aim of this study is to compare ILAE classification (1989) and Panayiotopoulos' criteria (1997) for absence epilepsies. We studied 455 typical absences (ILAE, 1981) by video-EEG in 43 patients with normal neurological and neuroradiological examinations and interictal EEG with spike-wave complexes higher than 2.5Hz. Syndromic diagnosis was possible in 60.5% and 67.4% of the patients using ILAE classification and Panayiotopoulos' proposal, respectively. According to ILAE criteria 19 patients had childhood absence epilepsy (CAE), five juvenile absence epilepsy (JAE), one juvenile myoclonic epilepsy (JME) and one epilepsy with specific modes of seizure precipitation. According to Panayiotopoulos' proposal, 10 had CAE, 14 JAE, one JME, three myoclonic absence epilepsy and one eyelid myoclonia with absences. We conclude that Panayiotopoulos' criteria and ILAE classification for absence epilepsies, which did not allow for the classification of 32.6% and 39.5% of cases, respectively, were still insufficient to classify all patients under specific diagnosis.

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Genetic generalized epilepsy

10.1093/med/9780199688395.003.0027 ◽

2016 ◽

Author(s):

Friederike Moeller ◽

Ronit M. Pressler ◽

J. Helen Cross

Keyword(s):

Clinical Presentation ◽

Age Of Onset ◽

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy ◽

Juvenile Absence Epilepsy ◽

Generalized Epilepsy ◽

Treatment Prognosis ◽

Electroencephalogram Eeg ◽

Eeg Features

This chapter provides an overview of generalized epilepsies (GGE), which comprises a group of epilepsy syndromes of presumed genetic origin. They are classified into several syndromes according to their age, depending on clinical manifestation and associated electroencephalogram (EEG) features. The chapter introduces the concept of GGE before addressing different GGE syndromes, describing their clinical presentation, EEG features, treatment, prognosis, and underlying genetics. The following GGE syndromes are discussed in order of their age of onset—myoclonic astatic epilepsy, childhood absence epilepsy, epilepsy with myoclonic absences, eyelid myoclonia with absences, juvenile absence epilepsy, juvenile myoclonic epilepsy, and epilepsy with generalized tonic seizures on awakening. This is followed by an overview on pathophysiological mechanisms underlying GGE.

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Seizure Exacerbation by Antiepileptic Drugs

Epilepsy Currents ◽

10.1111/j.1535-7511.2005.00061.x ◽

2005 ◽

Vol 5 (5) ◽

pp. 192-193 ◽

Cited By ~ 2

Author(s):

Jacqueline A. French

Keyword(s):

Antiepileptic Drugs ◽

De Novo ◽

Focal Epilepsy ◽

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Absence Seizures ◽

Incorrect Diagnosis ◽

Juvenile Absence Epilepsy ◽

Generalized Epilepsy

Worsening of Seizures by Oxcarbazepine in Juvenile Idiopathic Generalized Epilepsies Gelisse P, Genton P, Kuate C, Pesenti A, Baldy-Moulinier M, Crespel A Epilepsia 2004;45:1282–1286 Purpose Several studies have shown that carbamazepine (CBZ) may aggravate idiopathic generalized epilepsy (IGE). Oxcarbazepine (OXC) is a new drug chemically related to CBZ. We report six cases of juvenile IGE with a clear aggravation by OXC. Methods We retrospectively studied all patients with IGE first referred to our epilepsy department between January 2001 and June 2003 and treated with OXC. Results During this period, six patients were identified. All had an aggravation of their epilepsy in both clinical and EEG activities. OXC had been used because of an incorrect diagnosis of focal epilepsy or generalized tonic–clonic seizures (GTCSs) of undetermined origin (no syndromic classification of the epilepsy). Before OXC, only one patient had experienced a worsening of seizures with an inadequate drug (carbamazepine; CBZ). Four had juvenile myoclonic epilepsy, one had juvenile absence epilepsy, and one had IGE that could not be classified into a precise syndrome. OXC (dosage range, 300–1,200 mg/day) was used in monotherapy in all of them except for one patient. Aggravation consisted of a clear aggravation of myoclonic jerks (five cases) or de novo myoclonic jerks (one case). Three patients had exacerbation of absence seizures. One patient had worsened dramatically and had absence status, and one had de novo absences after OXC treatment. The effects of OXC on GTCSs were less dramatic, with no worsening in frequency in three and a slight increase in three. Conclusions OXC can be added to the list of antiepileptic drugs that can exacerbate myoclonic and absence seizures in IGE.

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Occipital intermittent rhythmic delta activity in absence epilepsy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000200004 ◽

2006 ◽

Vol 64 (2a) ◽

pp. 193-197 ◽

Cited By ~ 14

Author(s):

Laura M.F.F. Guilhoto ◽

Maria Luíza G. Manreza ◽

Elza M.T. Yacubian

Keyword(s):

Prognostic Factor ◽

Absence Epilepsy ◽

Common Finding ◽

Seizure Type ◽

Childhood Absence Epilepsy ◽

Delta Activity ◽

Clonic Seizures ◽

Rhythmic Delta Activity ◽

Video Eeg ◽

Spike Wave

Occipital intermittent rhythmic delta activity (OIRDA) is considered good prognostic factor in typical absences (TA). We report electroclinical evolution in 14 patients with TA and OIRDA, which performed video-EEG. Seven patients were female; 9 had childhood absence epilepsy and the others did not present electroclinical characteristics for syndromic classification according to ILAE's classification (1989). Pyknolepsy was referred to in 13; TA was the only seizure type in 13; one had generalized tonic-clonic seizures (GTCS) and three had myoclonic jerks during TA. VPA monotherapy controlled seizures in 11, diVPA and ESM, in one each. After seizure control EEG normalized in 10 while in three, spike-wave complexes (SWC) persisted, accompanied by OIRDA in one. Finally in another, seizures were not controlled and SWC and OIRDA persisted. In conclusion, we observed in this series of TA and OIRDA with onset before 10 years, pyknolepsy as common finding and few GTCS. VPA controlled seizures in most cases and EEG normalized in 76.92%. We suggest that OIRDA could be considered good prognostic factor in TA associated with SWC and of epileptiform nature leading to appropriate investigation.

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Co-existence of Rolandic and 3 Hz Spike-Wave Discharges on EEG in Children with Epilepsy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.364 ◽

2018 ◽

Vol 46 (1) ◽

pp. 64-70 ◽

Cited By ~ 3

Author(s):

Anita N. Datta ◽

Laura Wallbank ◽

Peter K. H. Wong

Keyword(s):

Clinical Data ◽

Seizure Control ◽

Age Of Onset ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy ◽

Drug Induced ◽

Favorable Prognosis ◽

Spike Wave Discharges ◽

Spike Wave

AbstractObjectiveBenign epilepsy of childhood with central temporal spikes (BECTS) and absence epilepsy are common epilepsy syndromes in children with similar age of onset and favorable prognosis. However, the co-existence of the electrocardiogram (EEG) findings of rolandic spike and 3 Hz generalized spike-wave (GSW) discharges is extremely rare, with few cases reported in the literature. Our objective was to characterize the EEG findings of these syndromes in children in our center and review the electro-clinical features.MethodsAll EEGs at BC Children’s Hospital are entered in a database, which include EEG findings and clinical data. Patients with both centro-temporal spikes and 3 Hz GSW discharges were identified from the database and clinical data were reviewed.ResultsAmong the 43,061 patients in the database from 1992 to 2017, 1426 with isolated rolandic discharges and 528 patients with isolated 3 Hz GSW discharges were identified, and 20 (0.05%) patients had both findings: 3/20 had BECTS, and subsequently developed childhood absence epilepsy and 17/20 had no seizures characteristic for BECTS. At follow-up, 17 (85%) were seizure-free, 1 (5%) had rare, and 2 (10%) had frequent seizures.ConclusionsThis is the largest reported group of patients to our knowledge with the co-existence of rolandic and 3 Hz GSW discharges on EEGs in one institution, not drug-induced. As the presence of both findings is extremely rare, distinct pathophysiological mechanisms are likely. The majority had excellent seizure control at follow-up, similar to what would be expected for each type of epilepsy alone.

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Long-term prognosis of typical childhood absence epilepsy: Remission or progression to juvenile myoclonic epilepsy

Neurology ◽

10.1212/wnl.47.4.912 ◽

1996 ◽

Vol 47 (4) ◽

pp. 912-918 ◽

Cited By ~ 126

Author(s):

E. C. Wirrell ◽

C. S. Camfield ◽

P. R. Camfield ◽

K. E. Gordon ◽

J. M. Dooley

Keyword(s):

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Myoclonic Epilepsy ◽

Childhood Absence Epilepsy ◽

Long Term Prognosis

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The Ketogenic Diet and Related Therapies in “Novel” Situations

10.1093/med/9780190497996.003.0008 ◽

2016 ◽

Author(s):

Sudha Kilaru Kessler

Keyword(s):

Ketogenic Diet ◽

Treatment Option ◽

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Myoclonic Epilepsy ◽

Childhood Absence Epilepsy ◽

Idiopathic Generalized Epilepsy ◽

Generalized Epilepsy

The ketogenic diet (KD) is often considered as a treatment option for medication-resistant focal epilepsies and symptomatic generalized epilepsies, but is perhaps less commonly considered for idiopathic generalized epilepsies. The evidence for the use of the KD in two common idiopathic generalized epilepsy syndromes, childhood absence epilepsy and juvenile myoclonic epilepsy, is presented here.

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