Concordance between the interictal focal EEG pattern and MRI lesions as a predictor of a favorable surgical outcome in patients with epileptic spasms: a Chinese study

2019 ◽  
Vol 23 (4) ◽  
pp. 422-431 ◽  
Author(s):  
Cuiping Xu ◽  
Tao Yu ◽  
Guojun Zhang ◽  
Gary B. Rajah ◽  
Yuping Wang ◽  
...  
Keyword(s):  
Seizure Frequency ◽  
Surgical Outcome ◽  
Epileptic Spasms ◽  
Select Group ◽  
Chinese Study ◽  
Interictal Eeg ◽  
Atypical Absence ◽  
Multilobar Resection ◽  
Age Range ◽  
Eeg Pattern

OBJECTIVEThe aim of this study was to evaluate the electro-clinical features, etiology, treatment, and postsurgical seizure outcomes in patients with intractable epileptic spasms (ESs).METHODSThe authors retrospectively studied the medical records of all patients who had presented with medically intractable ESs and had undergone surgery in the period between October 2009 and August 2015. The interictal electroencephalography (EEG) pattern, MRI studies, magnetoencephalography findings, and postsurgical seizure outcomes were compared.RESULTSTwenty-six patients, 12 boys and 14 girls (age range 3–22 years), were eligible for study inclusion. Of these 26 patients, 84.6% (22) presented with multiple seizure types including partial seizures (PSs) independent of the ESs (30.8%); ESs followed by tonic seizures (30.8%); myoclonic seizures (19.2%); tonic seizures (19.2%); ESs followed by PSs (19.2%); focal seizures with secondary generalization (15.4%); atypical absence (11.5%); PSs followed by ESs (7.7%); and myoclonic followed by tonic seizures (7.7%). Seventeen patients underwent multilobar resection and 9 underwent unilobar resection. At the last follow-up (mean 36.6 months), 42.3% of patients were seizure free (outcome classification [OC] 1), 23.1% had > 50% reduction in seizure frequency (OC2–OC4), and 34.6% had < 50% reduction in seizure frequency or no improvement (OC5 and OC6). Predictors of favorable outcomes included an interictal focal EEG pattern and concordance between interictal EEG and MRI-demonstrated lesions (p = 0.001 and 0.004, respectively).CONCLUSIONSA favorable surgical outcome is achievable in a highly select group of patients with ESs secondary to structural lesions. Interictal EEG can help in identifying patients with the potential for favorable resective outcomes.

scholarly journals Patient-assessed satisfaction and outcome after microsurgical resection of cavernomas causing epilepsy

2010 ◽  
Vol 29 (3) ◽  
pp. E16 ◽  
Author(s):  
Jamie J. Van Gompel ◽  
W. Richard Marsh ◽  
Fredric B. Meyer ◽  
Gregory A. Worrell
Keyword(s):  
Seizure Frequency ◽  
Intractable Epilepsy ◽  
Survey Study ◽  
Intractable Seizures ◽  
Select Group ◽  
Age At Surgery ◽  
Survey Results ◽  
Microsurgical Resection

Object Microsurgical resection of supratentorial cavernomas associated with intractable epilepsy is performed frequently. Despite its common occurrence, little is known about patient perceptions of microsurgical resection for cavernomas. This survey study was performed to investigate patient perceived outcome after surgery for cavernomas associated with intractable epilepsy. Methods The authors' surgical database was searched for cavernoma resection performed between 1971 and July of 2006. Of the initial 173 patients identified, 102 met criteria for medically intractable seizures. These 102 patients were then mailed a survey to determine follow-up and patient satisfaction. Thirty-nine surveys were returned as undeliverable, and 30 (48%) of the remaining 63 patients responded. Results The average age at surgery for patients responding to this survey was 40 ± 16 years compared with 35 ± 15 years for all 102 patients. At prolonged follow-up, 87% of patients reported being seizure-free. Of those with seizures, 2 (7%) reported being nearly seizure-free (rare disabling seizures), 2 (7%) believed they had a worthwhile improvement in seizure frequency, and no patient (0%) in this series believed they did not have a worthwhile improvement in seizure frequency. Ninety percent of responders stated they definitely, and 10% probably, would have surgery again. No patient responded that they probably or definitely would not have epilepsy surgery. Mean clinical follow-up was 36 ± 8 months and survey follow-up was 97 ± 13 months for these 30 patients. Use of the mail-in survey increased follow-up length 2.7 times longer compared with clinical follow-up. Conclusions It is clear from this select group of survey responders that patients undergoing surgery for cavernomas associated with medically intractable epilepsy are happy they underwent surgery (100%) and had excellent surgical outcomes (87% seizure-free) at prolonged follow-up of 97 ± 13 months. These survey results support that microsurgical resection for cavernomas is highly effective and significantly improves these patients' quality of life.

scholarly journals Surgical outcome of multiple intracranial aneurysms

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Mubashir Ahmed ◽  
Anjum Habib Vohra
Keyword(s):  
Surgical Outcome ◽  
Glasgow Outcome Scale ◽  
Intracranial Aneurysms ◽  
Clinical Presentation ◽  
Metabolic Disturbance ◽  
Ruptured Aneurysm ◽  
Multiple Intracranial Aneurysms ◽  
Good Outcome ◽  
Ct Brain ◽  
Age Range

Multiple intracranial aneurysms are relatively uncommon among patients of intracranial aneurysms. The aim of management has traditionally been the same i.e. clipping of all the aneurysms to eliminate the risk of rebleed. This study was conducted to determine the outcome of patients of multiple intracranial aneurysms at Mayo Hospital Lahore, Pakistan. The study period was from September 1999 to January 2002. Four patients were diagnosed having multiple intracranial aneurysms. Age range was 40 to 65 years and 2 (50%) patients were female. Patients were assessed according to Hunt & Hess grade. Clinical presentation was favoring the site of ruptured aneurysm in one patient and CT brain was suggestive of site in two patients. All patients had 2 aneurysms. In three (75%) cases, aneurysm were unilateral and in one (25%) case, bilateral. Half (50%) patients had clipping of aneurysms through single craniotomy and half (50%) had bilateral craniotomies. Outcome was graded according to Glasgow Outcome Scale. Three (7 5%) patients had good outcome and one (25%) patient died after clipping of aneurysms due to vasospasm, infarction and metabolic disturbance.

scholarly journals P.052 Benign spasms of infancy - a mimicker of infantile epileptic disorders

2019 ◽  
Vol 46 (s1) ◽  
pp. S28
Author(s):  
J Ghossein ◽  
D Pohl
Keyword(s):  
Epileptiform Activity ◽  
Positive Family History ◽  
Myoclonic Epilepsy ◽  
First Year ◽  
Neurodevelopmental Outcomes ◽  
Epileptic Spasms ◽  
Ictal Eeg ◽  
Interictal Eeg ◽  
Eeg Recordings ◽  
First Year Of Life

Background: Benign spasms of infancy (BSI), previously described as benign non-epileptic infantile spasms or benign myoclonus of early infancy, are non-epileptic movements manifesting during the first year of life and spontaneously resolving in the second year of life. BSI are characterized by spasms typically lasting 1-2 seconds, involving to varying degrees the head, neck, trunk, shoulders and upper extremities. Ictal and interictal EEG recordings are normal. BSI are not associated with developmental retardation and do not require treatment. Distinction between BSI and infantile epileptic disorders, such as epileptic spasms or myoclonic epilepsy of infancy, can be challenging given the clinical similarities. Moreover, interictal EEGs can be normal in all conditions. Epileptic spasms and myoclonic epilepsy require timely treatment to improve neurodevelopmental outcomes. Methods: We describe a 6-month old infant presenting with spasm-like movements. His paroxysms as well as a positive family history for epileptic spasms were in keeping with a likely diagnosis of West syndrome. Results: Surprisingly, ictal video EEG did not reveal epileptiform activity, and suggested a diagnosis of BSI. Conclusions: We emphasize that ictal EEG is the gold standard for classification of infantile paroxysms as either epileptic or non-epileptic, thereby avoiding overtreatment of BSI and facilitating timely targeted treatment of infantile epilepsies.

scholarly journals Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Channaiah Srikanth Mysore ◽  
Najib Murr ◽  
Rana Zabad ◽  
John Bertoni
Keyword(s):  
Status Epilepticus ◽  
Altered Mental Status ◽  
Progressive Multiple Sclerosis ◽  
Absence Status ◽  
History Of ◽  
Eeg Changes ◽  
Neurological Conditions ◽  
Atypical Absence ◽  
Eeg Pattern

Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive atypical absence status epilepticus (AS), with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity. A diagnosis of NCSE with clinical features of AS was made based on both clinical and EEG features. There was significant clinical and electrographic improvement with administration of levetiracetam for both patients in addition to sodium valproate and Solumedrol for the SREAT patient. Both patients continued to be seizure free on follow-up few months later. Conclusions. This is a report of two cases of atypical AS, with atypical EEG, in patients with different neurological conditions. Prompt clinical and EEG recovery occurred following appropriate medical treatment. We think that this condition might be underreported and could significantly benefit from prompt treatment when appropriately diagnosed.

scholarly journals Outcome of myringoplasty

1970 ◽  
Vol 15 (2) ◽  
pp. 40-44 ◽  
Author(s):  
Mani Lal Aich ◽  
ABM Khorshed Alam ◽  
Debesha Chandra Talukder ◽  
Abdullah Al Harun ◽  
M Abdullah
Keyword(s):  
Observational Study ◽  
Surgical Outcome ◽  
Tertiary Level ◽  
Temporalis Fascia ◽  
Cross Sectional ◽  
The Mean ◽  
Age Range ◽  
Level Hospital ◽  
Outcome Of Surgery ◽  
Air Conduction

A cross sectional, observational study was carried out on myringoplasty at a tertiary level hospital, with the aims to see the outcome of surgery. The study included 100 myringoplasty in central dry perforations of tubotympanic variety of CSOM. Age range of patients was from 15 years to 45 years; male was 56%.There was insignificant influences of age or sex on success rate. The surgeries were done under either local or general anaesthesia by underlay technique with temporalis fascia as a graft in all cases with different approaches without any significant influences on outcome. Site and size of the perforations had significant effect on surgical outcome. The overall graft take rate was 84%. The mean preoperative and postoperative air conduction threshold in the successful cases were 35.2dB & 24.1dB respectively with a mean audiological improvement of 11.1dB & air bone gap improvement was 12.4dB. Key words: Myringoplasty, outcome. DOI: 10.3329/bjo.v15i2.5054 Bangladesh J Otorhinolaryngol 2009; 15(2): 40-44

Interictal EEG pattern in rabbit penicillin epilepsy

1986 ◽  
Vol 7 (4) ◽  
pp. 413-420
Author(s):  
G. Gallitto ◽  
R. Musolino ◽  
M. Bonanzinga ◽  
P. De Domenico ◽  
G. Distefano ◽  
...  
Keyword(s):  
Interictal Eeg ◽  
Eeg Pattern

Interictal EEG pattern in West syndrome

2015 ◽  
Vol 126 (9) ◽  
pp. e176-e177
Author(s):  
R. Kravljanac ◽  
M. Ðurić ◽  
B. Tadić
Keyword(s):  
West Syndrome ◽  
Interictal Eeg ◽  
Eeg Pattern
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