دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
-
http://medilib.ir
- ﻣﺪﺕ ﺯﻣﺎﻥ : 365 ﺭﻭﺯ
قیمت : 3,800,000 تومان- قیمت ویژه : 1,900,000تومان
Imaging characteristics of temporopolar blurring in the context of hippocampal sclerosis
Carlos Andrés Clavijo Prado, Paolo Federico, Andrea Bernasconi, Boris Bernhardt, Lorenzo Caciagli, Luis Concha, Yotin Chinvarun, Graeme Jackson, Victoria Morgan, Stefan Rampp, Anna Elisabetta Vaudano, Irene Wang, Shuang Wang, Bruna Cunha Zaidan, Fabio Rogerio, Fernando Cendes
doi : 10.1684/epd.2021.1378
Pages: 1-8 First Published: 15 February 2022
We present an illustrative case to address anterior temporal lobe atrophy with poor delineation of the temporopolar gray-white matter interface based on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images in patients with temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS). A 52-year-old woman with pharmacoresistant seizures since the age of six months underwent a previous MRI scan using a suboptimal protocol which was reported as unremarkable. MRI performed according to an epilepsy protocol showed classic signs of left HS and ipsilateral temporal polar atrophy with blurring of the gray-white matter boundary on FLAIR images. She underwent a left amygdalohippocampectomy and anterior temporal resection and remains seizure-free after 24 months. Histopathological analyses showed HS and no signs of focal cortical dysplasia (FCD). Blurring and atrophy of the ipsilateral temporal pole are common in TLE-HS and often misinterpreted as FCD. This relates to delayed myelination in patients with seizures before the age of two, is more pronounced on FLAIR sequences, and gives a false impression of cortical thickening. However, the T1-weighted images show a relatively well-demarcated cortical-subcortical transition and normal cortical thickness. By contrast, the cortical thickening in FCD is observed on both T1-weighted and FLAIR images. Since FCD also occurs in temporal lobe regions, it is important to differentiate the extra-hippocampal MRI abnormalities in TLE-HS from those likely to be FCD. This case highlights the importance of evaluation based on detailed imaging, which should always be conducted considering the EEG, seizure semiology, and other clinical information.
Epilepsy in adults with neurodevelopmental disability - what every neurologist should know
Lance V. Watkins, Christine Linehan, Christian Brandt, Francesca Snoeijen-Schouwenaars, Paula McGowan, Rohit Shankar
doi : 10.1684/epd.2021.1366
Pages: 9-25 First Published: 15 February 2022
This seminar in epileptology addresses Learning Objective 6.1.4 of the International League against Epilepsy Curriculum: Demonstrate the ability to recognize and manage the special needs of persons with epilepsy (and Neurodevelopmental Disorders [NDDs]). The review identifies the essential competencies for neurologists working with people with epilepsy and NDDs, and these competencies are discussed alongside clinical examples. Furthermore, the seminar explores the opportunities offered by integrated service provision between neurology and services for NDD. The epileptic encephalopathies are not a subject of this seminar paper as they are circumscribed by other ILAE learning objectives. This seminar frames the complexity of seizures in association with NDD with a focus on major NDDs; intellectual disability, autism spectrum disorder, and attention deficit hyperactivity disorder. The evidence presented considers epidemiology, co-morbidities, risk factors, mortality, and the diagnostic and treatment challenges. People with NDDs and epilepsy have higher rates of physical and psychiatric co-morbidity, polypharmacy, neuropsychiatric side effects of drugs, and premature mortality including sudden unexpected death in epilepsy. There is a limited Level 1 evidence base to guide assessment and treatment for seizures in adults with NDDs. Therefore, throughout this seminar, the evidence presented for associations and treatment should be observed in context along with its limitations. The evidence for pharmacological treatment of seizures in association with NDDs is presented alongside expert commentary and guidance. There is Level 2 evidence to support treatment with some of the newer anti-seizure medications including brivaracetam, lacosamide, eslicarbazepine acetate, and perampanel as second-line choices. Seizures with a co-morbid NDD should be considered as a collective complex clinical presentation and not discrete conditions. This seminar was co-designed, co-produced and co-authored by an expert by experience and includes case studies and a video to highlight what can go wrong and how it can be avoided.
Acute symptomatic seizures: an educational, evidence-based review
Matthias Mauritz, Lawrence J. Hirsch, Peter Camfield, Richard Chin, Raffaele Nardone, Simona Lattanzi, Eugen Trinka
doi : 10.1684/epd.2021.1376
Pages: 26-49 First Published: 15 February 2022
Acute symptomatic seizures occurring in close temporal relationship with an acute CNS insult are distinct from epilepsy and occur frequently in clinical practice. The aim of this educational review is to provide information on the most important aspects related to acute symptomatic seizures that will allow clinicians to accurately distinguish acute symptomatic seizures from epilepsy in their patients. We explain the definition of acute symptomatic seizures and we illustrate how acute symptomatic seizures differ from epilepsy. We describe acute symptomatic seizures in the context of their various underlying aetiologies and we discuss the approach to the management of patients with acute symptomatic seizures.
Knowledge gaps for functional outcomes after multilobar resective and disconnective pediatric epilepsy surgery: Conference Proceedings of the Patient-Centered Stakeholder Meeting 2019
Monika Jones, William B. Harris, M. Scott Perry, Marlene Behrmann, Joanna Christodoulou, Aria Fallah, Bryan Kolb, Frank Musiek, Lynn K. Paul, Klajdi Puka, Cynthia Salorio, Raman Sankar, Mary Lou Smith, Ahsan Moosa Naduvil Valappil, Patricia Walshaw, Howard L. Weiner, Raymond Woo, Phillip Zeitler, Taylor J. Abel
doi : 10.1684/epd.2021.1373
Pages: 50-66 First Published: 15 February 2022
For children with medication-resistant epilepsy who undergo multilobar or hemispheric surgery, the goal of achieving seizure freedom is met with a variety of potential functional consequences, both favorable and unfavorable. However, there is a paucity of literature that comprehensively addresses the cognitive, medical, behavioral, orthopedic, and sensory outcomes across the lifespan following large epilepsy surgeries in childhood, leaving all stakeholders underinformed with regard to counseling and expectations. Through collaboration between clinicians, researchers, and patient/caregiver stakeholders, the “Functional Impacts of Large Resective or Disconnective Pediatric Epilepsy Surgery: Identifying Gaps and Setting PCOR Priorities� meeting was convened on July 18, 2019, to identify gaps in knowledge and inform various patient-centered research initiatives. Clinicians and researchers with content expertise presented the best available data in each functional domain which is summarized here. As a result of the meeting, the top three consensus priorities included research focused on postoperative: (1) hydrocephalus; (2) mental health issues; and (3) literacy and other educational outcomes. The proceedings of this meeting mark the first time research on functional outcomes after resective and disconnective pediatric epilepsy surgery has been codified and shared among multidisciplinary stakeholders. This joint initiative promotes continued collaboration in the field and ensures that advancements align with actual patient and family needs and experiences. Collaboration around common objectives will lead to better informed counseling around postoperative expectations and management for children undergoing epilepsy surgery.
Limb loss experience evoked by electric cortical stimulation
Guiliang Hao, Xueyuan Wang, Hao Yan, Liu He, Duanyu Ni, Liang Qiao, Xiaohua Zhang, Kaijia Yu, Tao Yu
doi : 10.1684/epd.2021.1364
Pages: 67-74 First Published: 15 February 2022
Objective. Limb loss experience is a type of body illusion characterized by the sensation of a missing limb or body part. We aimed to investigate the brain areas involved in this unusual somatosensory experience evoked by electric cortical stimulation with stereo-electroencephalography electrodes.
Etiology and prognostic significance of ictal EEG patterns in patients with non-convulsive seizures
Jaysingh Singh, Mangala Gopal, Assad Amin, Juan Peng
doi : 10.1684/epd.2021.1363
Pages: 75-81 First Published: 15 February 2022
Objective. We aimed to study the ictal EEG patterns in patients with non-convulsive seizures (NCS) and their relationship with underlying etiology and patient outcome.
Burden of seizures and comorbidities in patients with epilepsy: a survey based on the tertiary hospital-based Epilepsy Syndrome Registry in Japan
Yushi Inoue, Shin-ichiro Hamano, Masaharu Hayashi, Hiroshi Sakuma, Shinichi Hirose, Atsushi Ishii, Ryoko Honda, Akio Ikeda, Katsumi Imai, Kazutaka Jin, Akiko Kada, Akiyoshi Kakita, Mitsuhiro Kato, Kensuke Kawai, Tamihiro Kawakami, Katsuhiro Kobayashi, Toyojiro Matsuishi, Takeshi Matsuo, Shin Nabatame, Nobuhiko Okamoto, Susumu Ito, Akihisa Okumura, Akiko Saito, Hideaki Shiraishi, Hiroshi Shirozu, Takashi Saito, Hidenori Sugano, Yukitoshi Takahashi, Hitoshi Yamamoto, Tetsuhiro Fukuyama, Ichiro Kuki, (Japan Rare Epilepsy Syndrome Registry Group: JRESG)
doi : 10.1684/epd.2021.1361
Pages: 82-94 First Published: 15 February 2022
Objective. To examine the current medical and psychosocial status of patients with epilepsy, aiming to facilitate appropriate application of the Intractable/Rare Diseases Act of Japan.
Prevalence of various risk factors associated with new-onset epilepsy after the age of 50: a retrospective population-based study
Emilija Cvetkovska, Marija Babunovska, Bojan Boskovski, Igor Kuzmanovski, Nikolina Tanovska, Gordana Kiteva Trencevska
doi : 10.1684/epd.2021.1360
Pages: 95-101 First Published: 15 February 2022
Objective. Population-based studies of epilepsy risk factors are rare. We aimed to evaluate the prevalence of various risk factors associated with new-onset epilepsy after the age of 50 years. We included all incident cases in North Macedonia between 2015 and 2018.
Relationship between location of epileptic focus and occurrence during sleep versus wakefulness
Pooja Narang, Divyani Garg, Garima Shukla, Mamta Bhushan Singh, Achal Srivastava, Anupama Gupta, Ashish Suri, Ajay Garg, CS. Bal, Deepti Vibha, Awadh Kishor Pandit, Kameshwar Prasad
doi : 10.1684/epd.2021.1362
Pages: 103-110 First Published: 15 February 2022
Objective. Different sleep stages exert differential effects on interictal discharges, neural synchrony and seizure threshold. We sought to assess the relationship between localization of the epileptogenic focus and seizure distribution in sleep versus wakefulness among patients with refractory epilepsy.
Children with seizures and radiological diagnosis of focal cortical dysplasia: can drug-resistant epilepsy be predicted earlier?
Ido Ben Zvi, Noelle Enright, Felice D'arco, M. Zubair Tahir, Aswin Chari, J. Helen Cross, Christin Eltze, Martin M. Tisdall
doi : 10.1684/epd.2021.1368
Pages: 111-122 First Published: 15 February 2022
Objective. Focal cortical dysplasia (FCD) is a malformation of cortical development and is associated with drug-resistant epilepsy. Standard indication for epilepsy surgery is drug resistance (as defined by the ILAE). Given the high incidence of drug resistance in these children, this delay may not be warranted. The aim of the study was to determine the proportion of patients with a presumed FCD who develop drug resistance, and evaluate post-operative outcomes.
Evaluation of real-world effectiveness of perampanel in Japanese adults and older adults with epilepsy
Yushi Inoue, Kenta Sumitomo, Kazuhiro Matsutani, Mika Ishii
doi : 10.1684/epd.2021.1369
Pages: 123-132 First Published: 15 February 2022
Objective. While previous studies have demonstrated the safety and effectiveness of perampanel (PER) in combination with other anti-seizure medications in adult patients, data for older patients are limited. This study aimed to confirm real-world safety and effectiveness of combination treatment with PER in Japanese patients with focal seizures with or without focal to bilateral tonic-clonic seizures (FBTCS) or generalised tonic-clonic seizures (GTCS) according to age subgroups (<65 and ≥65 years of age).
Determinants of postictal agitation and recovery after tonic-clonic seizures in generalized and focal epilepsy∗
Aman Dabir, Salman Zahoor, Bassel W. Abou-Khalil
doi : 10.1684/epd.2021.1371
Pages: 133-139 First Published: 15 February 2022
Objective. The postictal state after bilateral tonic-clonic seizures is often prolonged and can have significant impact on a patient's quality of life. Considerable variability exists in the magnitude of postictal agitation and in the speed of recovery, the determinants of which are not well understood. We studied postictal behavior after tonic-clonic seizures in various epilepsy localizations, focusing on postictal agitation and time to responsiveness.
Beyond neonatal seizures - epileptic evolution in preterm newborns: a systematic review and meta-analysis
Raffaele Falsaperla, Laura Mauceri, Milena Motta, Giovanni Prezioso, Martino Ruggieri, Francesco Pisani
doi : 10.1684/epd.2021.1379
Pages: 140-150 First Published: 15 February 2022
Objective. To assess the potential risk of developing epilepsy in preterm newborns with neonatal seizures (NS). Two electronic databases (PubMed and Web of Sciences) were searched from inception to December 2020. Studies that investigated the outcome of epilepsy in neonates with NS were included.
De novo status epilepticus possibly related to battery depletion of anterior thalamic brain stimulator
Gadi Miron, Ido Strauss, Firas Fahoum
doi : 10.1684/epd.2021.1365
Pages: 151-155 First Published: 15 February 2022
Anterior thalamic deep brain stimulation is an effective therapeutic option for patients with drug-refractory focal epilepsy who are poor surgical candidates. Although the precise mechanism of action of thalamic neurostimulation is unknown, studies demonstrating increased efficacy over time have raised the possibility that therapeutic benefits are mediated by stimulation-related long-term neuroplastic changes. Adverse effects related to hardware malfunction have been previously described, and most commonly include local infection, sensory disturbances, and migration of leads. However, the withdrawal effect of sudden deep brain stimulation malfunction on seizure control is unclear. We present the case of a 21-year-old patient with intractable focal epilepsy who developed status epilepticus concurrently with unexpected deep brain stimulator battery failure, 21 months post implantation. This case demonstrates an unfamiliar possible adverse effect of anterior thalamic stimulation withdrawal and emphasizes the importance of stimulator hardware assessment in patients presenting with seizure worsening.
Flashing lights and epileptic spasms: should we be routinely performing intermittent photic stimulation in infants?
Marvin H. Braun, Naureen Jooma, Morris H. Scantlebury
doi : 10.1684/epd.2021.1370
Pages: 156-162 First Published: 15 February 2022
Abnormal cortical excitation in response to photic stimulation (photosensitivity) has historically been associated with generalized epilepsies, in patients outside of infancy. At our tertiary centre, we encountered a patient with infantile spasms secondary to a mutation in ALG13 (c320A>G) who had photic stimulation-induced epileptic spasms over a broad range of frequencies on multiple EEGs, which were worse without treatment and decreased as treatment was escalated. This is the first reported case of epileptic spasms triggered by photic stimulation and it is unclear whether the phenomenon is unique to this patient, to those with this mutation or whether it is present in a broader group of patients with infantile spasms.
Major intra-familial variability in Unverricht-Lundborg disease
Amina Nasri, Sabrina Zidi, Imen Kacem, Saloua Mrabet, Mouna Ben Djebara, Amina Gargouri, Eric Leguern, Riadh Gouider
doi : 10.1684/epd.2021.1372
Pages: 163-170 First Published: 15 February 2022
Unverricht-Lundborg disease (ULD), also called progressive myoclonic epilepsy type 1, is usually characterized by the presence of ataxia associated with myoclonus and epileptic seizures without progressive cognitive deficit, presenting during late childhood and early adolescence. Currently, there is a growing body of evidence for atypical presentations of the disease with a milder phenotype or without the full symptomatology. We describe a case report of a late-onset phenotype with progressive myoclonus-ataxia syndrome accompanied by initial recurrent falls, resulting in specific phobia and agoraphobia starting at the age of 50 years old. The examination revealed multifocal myoclonus with cerebellar ataxia and electroencephalogram showed generalized polyspikes and spike-wave discharges. Electromyogram revealed positive myoclonus of 60-ms duration in the face and the presence of C reflex. A genetic study confirmed the diagnosis of ULD in the patient and other additional family members, presenting a wide range of intra-familial variability. We discuss the challenging differential diagnosis for such a misleading presentation and its possible underlying pathophysiological mechanisms. Our case report may contribute to broadening the age and clinical boundaries for this disease and emphasizes the intra-familial age and symptom variability. Based on a suggestive family history, the diagnosis of ULD should be considered in this context, even in older patients.
ACTH for epileptic spasms in Leigh syndrome with SLC19A3 mutation can induce status dystonicus
Hiroki Hoshino, Hideaki Kanemura
doi : 10.1684/epd.2021.1374
Pages: 171-175 First Published: 15 February 2022
Patients with Leigh syndrome (LS) sometimes develop epileptic spasms (ES). ACTH treatment for ES may be effective without serious adverse events in some patients with LS. Status dystonicus is a life-threatening disorder characterized by an acute exacerbation of generalized dystonia and often develops as a triggered event. The underlying pathophysiology of status dystonicus remains unclear. To our knowledge, there has been no reported case of status dystonicus associated with ACTH treatment. Here, we describe the first reported patient with LS, harbouring compound heterozygous mutations in SLC19A3 gene, who developed status dystonicus following initial intramuscular injection of a course of ACTH treatment for ES. Stressors can precipitate acute exacerbation in SLC19A3-related disorders. Interestingly, in this patient, external discomfort stimuli tended to induce transient hypertonia with opisthotonos. This report suggests that attention should be paid to acute exacerbation of generalized dystonia when ACTH treatment for ES is started in patients with LS, who have dystonia tend to exacerbate transiently by external discomfort stimuli.
Epilepsia partialis continua associated with the p.Arg403Cys variant of the DNM1L gene: an unusual clinical progression with two episodes of super-refractory status epilepticus with a 13-year remission interval
Sara Minghetti, Roberto Giorda, Massimo Mastrangelo, Laura Tassi, Nicoletta Zanotta, Sara Galbiati, Maria Teresa Bassi, Claudio Zucca
doi : 10.1684/epd.2021.1375
Pages: 176-182 First Published: 15 February 2022
Dynamin-1-like (DNM1L) is a gene located on chromosome 12p11.21 that encodes for dynamin-related protein (DRP1), a GTPase involved in mitochondrial and peroxisomal fusion, which plays a pivotal role in brain development. The missense variant, p.Arg403Cys, is clinically associated with childhood-onset super-refractory status epilepticus, with either subsequent poor neurological outcome or death (described in 13 patients). We present a 20-year-old girl carrying this mutation with a history of two episodes of super-refractory focal myoclonic status epilepticus which manifested as epilepsia partialis continua (EPC) with a 13-year interval, during which she displayed moderate intellectual disability, social and school reintegration, without complete control of myoclonic manifestations. The first status, which occurred at the age of six, was associated with transient left side thalamic involvement and the second episode with right side transient basal ganglia hyperintensity on MRI. After the second status, a persistent vegetative state with both drug-resistant epilepsia partialis continua and reticular myoclonus endured; the MRI showed progressive brain atrophy. In contrast to previous published cases, this new case of childhood-onset DNM1L encephalopathy demonstrated biphasic clinical progression. The main features of our patient were EPC, super-refractory status epilepticus, and transient and migrating subcortical thalamic hyperintensity on MRI at onset. The unusual clinical course is also noticeable, indicating possible epigenetic and/or protective factors, without underestimating the progressive and genetic basis of this encephalopathy. Precise characterization of seizures and whole-exome sequencing are crucial in order to establish early diagnosis.
Progression of alternating hemiplegia of childhood-related focal epilepsy to electrical status epilepticus in sleep with reversible encephalopathy
Derek Neupert, Puya Abbassi, Lyndsey Prange, Robert Flamini, Mohamad A. Mikati
doi : 10.1684/epd.2021.1377
Pages: 183-190 First Published: 15 February 2022
Mutations in the ATP1A3 gene (which encodes the main α subunit in neuronal Na+/K+-ATPases) cause various neurological syndromes including alternating hemiplegia of childhood. This rare disorder is characterized by paroxysmal episodes of hemiplegia, dystonia, oculomotor abnormalities, and occasionally developmental regression. Approximately 50% of alternating hemiplegia of childhood patients also have epilepsy, which is either focal or generalized. Seizures are often drug resistant. We report a 10-year-old girl with the D801N ATP1A3 mutation and alternating hemiplegia of childhood who manifested with drug-resistant focal seizures as an infant and throughout childhood. At the age of about10.5 years, her epilepsy evolved into electrical status epilepticus in sleep with generalized discharges. These changes coincided with developmental regression consistent with epileptic encephalopathy. Additionally, MRI and MR spectroscopy showed new cortical atrophy and markedly depressed N-acetyl aspartate peaks compared to previous normal studies. Electrical status epilepticus in sleep resolved after medication adjustments. She, now, only four months after her diagnosis of electrical status epilepticus in sleep, has regained most of the skills that were lost only a few months earlier. Our observations document that alternating hemiplegia of childhood can result in the above-described unique features; particularly, progression of focal epilepsy to electrical status epilepticus in sleep with generalized features and reversible epileptic encephalopathy.
De novo psychosis after left temporal lobectomy: a case of forced normalization?
Marie Arthuis, Stanislas Lagarde, Aileen Mcgonigal, Fabrice Bartolomei
doi : 10.1684/epd.2021.1380
Pages: 191-196 First Published: 15 February 2022
Forced normalization is a clinical entity defined by the appearance of psychiatric disturbance following control of epileptic seizures that were previously uncontrolled. It was first described by Landolt in 1953. The first cases described were mostly psychosis, however, subsequent work suggested that any behavioural disturbance of acute/or subacute onset concomitant with seizure control could be considered as forced normalization. We report the case of a 65-year-old, right-handed Caucasian patient who was followed in the Epilepsy Centre of Marseille, for left temporal drug-resistant epilepsy. The frequency of seizures was one seizure per month at the time before surgery. Left anterior temporal lobectomy was proposed based on presurgical evaluation. The patient remained seizure-free after surgery, but he presented with an episode of acute psychosis three months after. At this point, EEG was performed, showing rare left temporal epileptiform activity mainly provoked by hyperventilation, with breach rhythm over the left temporal surgical. The appearance of acute psychosis after cessation of epileptic seizures and reduced epileptiform activity on the EEG led us to question the forced normalization process in this case. Another hypothesis would be the effect of surgery itself, since there is an increased risk of any psychiatric disturbance unrelated to seizure cessation during the postoperative period. In conclusion, psychosis in this case could have resulted from the combination of several factors, including the effect of surgery itself and seizure cessation. This case illustrates the need for specific psychiatric care in the perioperative period in patients with epilepsy.
Video game-induced reflex seizures via a smartphone
Antonella Riva, Erika Rebessi, Eliana Parente, Maurizio Viri, Pasquale Striano, Antonino Romeo
doi : 10.1684/epd.2021.1382
Pages: 197-201 First Published: 15 February 2022
Reflex seizures are consistently evoked by a specific afferent stimulus or by patient activity. Patients experiencing reflex seizures when playing a game on a mobile phone are rarely reported. We describe a boy with reflex seizures after prolonged exposure to the game, Cut the rope, on his mobile phone. The video-EEG documented electroclinical events characterized by distal myoclonic jerks of the upper limbs, in combination with irregular, diffuse spike-and-wave and polyspike-and-wave discharges on EEG, followed by a tonic-clonic seizure. Playing video games on mobile phones may potentially induce reflex seizures, similar to other commonly used platforms such as docking stations connected to video screens.
Focal status epilepticus may trigger relapse of primary angiitis of the CNS
Antoine Guilmot, Sofia Maldonado Slootjes, Thierry Duprez, Julie Lelotte, Martin Lammens, André Peeters, Susana Ferrao Santos
doi : 10.1684/epd.2021.1381
Pages: 203-207 First Published: 15 February 2022
The role of neuroinflammation in epileptogenesis is extensively investigated, but short-term effects of seizures on established CNS pathologies are less studied and less predictable. We describe the case of a woman with previous recurrent episodes of focal cerebral haemorrhage of unknown cause who developed a pseudo-tumoural oedema triggered by provoked focal status epilepticus. A brain biopsy revealed that the underlying condition was primary angiitis of the CNS. Ictal-induced blood-brain barrier dysfunction allows the entry of water and inflammatory molecules that, in the context of CNS inflammatory diseases, may trigger a self-reinforcing process. Caution should be observed when tapering antiepileptic drugs in patients with such conditions.
Continuous spikes and waves during slow sleep related to sulthiame?
Roberto Horacio Caraballo, Santiago Galicchio
doi : 10.1684/epd.2021.1359
Pages: 208-210 First Published: 15 February 2022
Ictal head roll: a seizure semiology from the anterior prefrontal lobe
Gabriela Tantillo, Hernan Nicolas Lemus, Nathalie Jetté, Saadi Ghatan, Fedor Panov, Dina Bolden, Madeline C. Fields
doi : 10.1684/epd.2021.1367
Pages: 211-218 First Published: 15 February 2022
Longstanding epilepsy can lead to modulation of cortical networks over time and unexpected seizure onset zones. Frontal lobe seizures, in particular, can have diverse semiologies and evolution patterns. We present a male patient with drug-resistant epilepsy secondary to severe traumatic brain injury who underwent bilateral stereo electroencephalography (SEEG) for surgical planning. SEEG localized an ictal circular head roll to the right anterior prefrontal region. This was followed by spread to the left orbitofrontal region and later the left amygdala and hippocampus, at which point a different semiology with behavioral arrest, lip smacking and oral automatisms began. This case, in which an ictal circular head roll was localized to the anterior prefrontal region, demonstrates the complexity of broad seizure networks that develop over time, leading to remote seizure spread.
Let's all repeat – palilalia may be epileptic!
Fábio A. Nascimento, Jay R. Gavvala
doi : 10.1684/epd.2021.1383
Pages: 219-220 First Published: 15 February 2022
