Fokal Başlangıçlı Bilateral Tonik Klonik Nöbetlerde Nöbet Süresi ile Demografik, Klinik ve Radyolojik Özellikler Arasındaki İlişkinin Araştırılması
Abstract
Video-elektroensefalografik izleme (VEM), nöbetlerin davranışsal ve elektroensefalografik (EEG) aktivite süresini objektif olarak değerlendirmek için altın standarttır. Bugüne kadar nöbet süreleri farklı hasta gruplarında klinik olarak veya EEG ile değerlendirilmiştir. Bu çalışma, VEM ile değerlendirilen fokal başlangıçlı bilateral tonik-klonik nöbet (FBTKN) tanısı olan epilepsi hastalarında, demografik, klinik ve nörogörüntüleme bulguları ile nöbet süresi arasındaki ilişkiyi ortaya koymayı amaçlamaktadır. Nisan 2005 ve Ocak 2024 tarihleri arasında merkezimizde FBTKN tanısı alan rastgele seçilmiş 58 hastanın tıbbi öyküleri, nörogörüntülemeler, VEM kayıtlarından elde edilen klinik ve iktal EEG bulguları retrospektif olarak analiz edildi. En kısa fokal aktivite frontal lob epilepsisinde ve en uzun jeneralize aktivite parietooksipital lob epilepsisindeydi. Fokal aktivite süresi frontal ve eksternal kapsül lokalizasyonlu lezyonlarda daha kısa, mezial temporal lokalizasyonda daha uzundu. Fokal aktivite süresi meziyal temporal sklerozda daha uzundu. Jeneralize aktivite süresi ensefalomalazi ve polimikrogiride daha uzun, kortikal displazide ise daha kısaydı. Lezyonlara kortikal atrofi eşlik ettiğinde fokal aktivite süresi daha kısaydı. Anti nöbet ilaç türü ile nöbet süreleri arasında herhangi bir korelasyon yoktu. Nöbet süreleri semiyolojik bulgulara, radyolojik özelliklere ve epilepsi sendromlarına göre değişebilir. Farklılıkları klinisyen için epilepsi sendromu türü, status olasığı, semiyolojik eşlik eden bulgular hakkında bilgi verici olabilir.
Keywords
Fokal Başlangıçlı Bilateral Tonik Klonik Nöbet Fokal aktivite süresi Jeneralize aktivite süresi İktal EEG
References
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Investigation of the Relationship Between Seizure Duration and Demographic, Clinical and Radiologic Characteristics in Focal to Bilateral Tonic-Clonic Seizures
Abstract
Video-electroencephalographic monitoring (VEM) is the gold standard for objectively assessing the duration of seizures' behavioral and electroencephalographic (EEG) activity. To date, EEG has clinically evaluated seizure durations in different patient groups. This study aims to reveal the relationship between demographic, clinical, and neuroimaging findings and seizure duration in epilepsy patients with focal onset bilateral tonic-clonic seizures (FBTCS) evaluated with VEM. Medical histories, neuroimaging, and clinical and ictal EEG findings obtained from VEM recordings of 58 randomly selected patients diagnosed with FBTCS in our center were retrospectively analyzed between April 2005 and January 2024. The shortest focal activity was in frontal lobe epilepsy, and the longest generalized activity was in parietooccipital lobe epilepsy. Focal activity duration was shorter in frontal and external capsule localized lesions and longer in mesial temporal localization. Focal activity duration was longer in mesial temporal sclerosis. The duration of generalized activity was longer in encephalomalacia and polymicrogyria and shorter in cortical dysplasia. Focal activity duration was shorter when lesions were accompanied by cortical atrophy. There was no correlation between the type of anti-seizure medication and seizure duration. Seizure duration may vary according to semiologic findings, radiologic features, and epilepsy syndromes. Their differences may inform the clinician about the type of epilepsy syndrome, the probability of status, and semiologic accompanying findings.
Keywords
Focal to Bilateral Tonic Clonic Seizure focal activity duration generalized activity duration Ictal eeg
References
- 1. Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46(4):470-2.
- 2. Specchio N, Wirrell EC, Scheffer IE, Nabbout R, Riney K, Samia P, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: Position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63(6):1398-442.
- 3. Zuberi SM, Wirrell E, Yozawitz E, Wilmshurst JM, Specchio N, Riney K, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63(6):1349-97.
- 4. Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia. 2006;47(9):1499-503.
- 5. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
- 6. Pan SP, Wang F, Zhang Y, Wang J. The electroclinical-semiology of generalized tonic-clonic seizures among different epilepsies. Eur Rev Med Pharmacol Sci. 2015;19(22):4249-53.
- 7. Moseley BD, Ghearing GR, Benarroch EE, Britton JW. Early seizure termination in ictal asystole. Epilepsy Res. 2011;97(1-2):220-4.
- 8. Lado FA, Moshe SL. How do seizures stop? Epilepsia. 2008;49(10):1651-64.
- 9. Zubler F, Steimer A, Gast H, Schindler KA. Seizure termination. Int Rev Neurobiol. 2014;114:187-207.
- 10. Dobesberger J, Ristic AJ, Walser G, Kuchukhidze G, Unterberger I, Hofler J, et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures--A video-EEG analysis. Epilepsy Behav. 2015;49:111-7.
- 11. Kaufmann E, Seethaler M, Lauseker M, Fan M, Vollmar C, Noachtar S, et al. Who seizes longest? Impact of clinical and demographic factors. Epilepsia. 2020;61(7):1376-85.
- 12. Meritam Larsen P, Wustenhagen S, Terney D, Gardella E, Aurlien H, Beniczky S. Duration of epileptic seizure types: A data-driven approach. Epilepsia. 2023;64(2):469-78.
- 13. Afra P, Jouny CC, Bergey GK. Duration of complex partial seizures: an intracranial EEG study. Epilepsia. 2008;49(4):677-84.
- 14. Theodore WH, Porter RJ, Albert P, Kelley K, Bromfield E, Devinsky O, et al. The secondarily generalized tonic-clonic seizure: a videotape analysis. Neurology. 1994;44(8):1403-7.
- 15. Pan S, Wang F, Wang J, Li X, Liu X. Factors influencing the duration of generalized tonic-clonic seizure. Seizure. 2016;34:44-7.
- 16. Stanley EM, Fadel JR, Mott DD. Interneuron loss reduces dendritic inhibition and GABA release in hippocampus of aged rats. Neurobiol Aging. 2012;33(2):431 e1-13.
- 17. Manford M, Fish DR, Shorvon SD. An analysis of clinical seizure patterns and their localizing value in frontal and temporal lobe epilepsies. Brain. 1996;119 ( Pt 1):17-40.
- 18. Bleasel A, Kotagal P, Kankirawatana P, Rybicki L. Lateralizing value and semiology of ictal limb posturing and version in temporal lobe and extratemporal epilepsy. Epilepsia. 1997;38(2):168-74.
- 19. Seethaler M, Lauseker M, Ernst K, Remi J, Vollmar C, Noachtar S, et al. Hemispheric differences in the duration of focal onset seizures. Acta Neurol Scand. 2021;143(3):248-55.
- 20. Nielsen JA, Zielinski BA, Ferguson MA, Lainhart JE, Anderson JS. An evaluation of the left-brain vs. right-brain hypothesis with resting state functional connectivity magnetic resonance imaging. PLoS One. 2013;8(8):e71275.
- 21. Schmitz J, Fraenz C, Schluter C, Friedrich P, Jung RE, Gunturkun O, et al. Hemispheric asymmetries in cortical gray matter microstructure identified by neurite orientation dispersion and density imaging. Neuroimage. 2019;189:667-75.
- 22. Hartl E, Seethaler M, Lauseker M, Remi J, Vollmar C, Noachtar S. Impact of withdrawal of antiepileptic medication on the duration of focal onset seizures. Seizure. 2019;67:40-4.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Neurology and Neuromuscular Diseases |
| Journal Section | Research Article |
| Authors | |
| Publication Date | May 17, 2024 |
| Submission Date | February 25, 2024 |
| Acceptance Date | April 16, 2024 |
| Published in Issue | Year 2024 Volume: 50 Issue: 1 |
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