1,721,001 research outputs found
Effetti della zonisamide sull’EEG: uno studio quantitativo ed ispettivo in pazienti epilettici.
No full textObstructive hydrocephalus mimicking a normal pressure condition as unusual presentation of basilar artery aneurysm: a case report
No full text[No abstract available
Ambroxol-Induced Focal Epileptic Seizure
No full textIt is well known that in epileptic patients some compounds and different drugs used for the treatment of comorbidities can facilitate or provoke seizures, this evidence regarding a wide spectrum of pharmacological categories. The potential facilitating factors usually include direct toxic effects or pharmacological interactions of either active ingredients or excipients. We report the case of a patient with drug-resistant epilepsy who experienced focal epileptic seizures, easily and constantly reproducible, after each administration of a cough syrup. This is, to our knowledge, the first electroencephalogram-documented case of focal epileptic seizures induced by cough syrup containing ambroxol as active ingredient
Switching from branded to generic antiepileptic drugs as a confounding factor and unpredictable diagnostic pitfalls in epilepsy management
No full textIctal epileptic headache in adult life: Electroclinical patterns and spectrum of related syndromes
No full textObjectives: Both headache and epilepsy are frequent paroxysmal disorders that often co-occur or are related in
numerous ways. Although ictal epileptic headache has become the focus of several studies, this remains a very
rare and notwell-known phenomenon. Electroclinical features, pathophysiology, and syndromic context are heterogeneous.
We investigated the electroclinical and neuroimaging findings in a population of adult patientswith
ictal epileptic headache.
Methods:We retrospectively examined 8800 EEG recordings of almost 4800 patients admitted to our video-EEG
laboratory from 2010 to 2013 with a history of well-documented epilepsy. We selected patients who reported
headache closely related to a seizure documented by video-EEG or 24-hour ambulatory EEG. We analyzed ictal
electroclinical features of headache, and we defined the related epileptic syndromes.
Results:Weidentified five patientswith ictal epileptic headache. Twopatients described tension headache during an
epileptic seizure. In three patients, the headache was accompanied by other “minor” neurological symptoms mimicking
amigrainous aura. In all cases, the headache stoppedwith the end of the epileptic activity. Three patients had
a history of partial symptomatic epilepsy with cerebral lesions (lowgrade glioma, astrocytoma, porencephalic cyst)
in the left posterior regions, whereas two patients were affected by idiopathic generalized epilepsy.
Conclusion: This study confirms the rarity of ictal epileptic headache. To date, well-documented video-EEG cases remain
as exceptional reports, especially in cases of idiopathic generalized epilepsies. Moreover,we confirm themain
involvement of posterior regions in patientswith ictal epileptic headache affected by partial symptomatic epilepsies
Over-interpretation of electroclinical and neuroimaging findings in syncopes misdiagnosed as epileptic seizures
No full textSyncope and epileptic seizures share some common clinical characteristics that may complicate the diagnostic process. In clinical practice, syncope is frequently misdiagnosed as an epileptic seizure and consequently treated with antiepileptic drugs. In this study, we identified 57 patients with syncope (diagnosis based on accepted criteria) who had come to our unit with a previous diagnosis of definite epilepsy in 30 cases (syncope misdiagnosed as epileptic seizures, SMS), or suspected epilepsy in the remaining 27 cases (unrecognized syncope, US). We attempted to identify factors underlying misdiagnosis by reviewing clinical findings, particularly potentially confounding features, and EEG/neuroimaging data. Finally, we compared these two groups of patients to search for crucial elements that had led to misdiagnosis. Although some clinical elements were found to be confounding in both groups, it was the interpretation of the EEG and MRI findings, particularly when combined with the confounding clinical features that constituted the main reasons for misdiagnosis
Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient
No full textIdiopathic photosensitive occipital lobe epilepsy (IPOE) is an idiopathic localization-related epilepsy characterized by age-related onset, specific mode of precipitation, occipital photic-induced seizures frequently consisting of visual symptoms and good prognosis. This uncommon epilepsy, which usually starts in childhood or adolescence, has rarely been observed in families in which idiopathic generalized epilepsy also affects other members. We describe a nuclear family in which the proband showed electro-clinical features of idiopathic photosensitive occipital lobe epilepsy in childhood, which subsequently evolved into absences and a single generalized tonico-clonic seizure in early adolescence. His mother had features suggestive of juvenile myoclonic epilepsy. This case illustrates a continuum between focal and generalized entities in the spectrum of the so-called idiopathic (genetically determined) epileptic syndromes. (C) 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved
Status epilepticus in epileptic patients. Related syndromes, precipitating factors, treatment and outcome in a video-EEG population-based study
No full textIntroduction: Status epilepticus (SE) is frequently observed in epileptic patients. We reviewed a series of video-EEG documented SE to define the characteristics of SE in this population. Materials and methods: Retrospective evaluation of 50 epileptic patients with SE, revision of the electro-clinical data and therapies, and definition of the semeiological subtypes, aetiology, outcome and related epileptic syndromes. Results: We identified 28 convulsive (19 focal and 9 generalized) and 22 non-convulsive (8 focal and 14 generalized) SE patients. In 13 patients, SE was situation-related (poor compliance, AED reduction, worsening seizures). In the remaining 37 patients, SE was related to the natural history of epilepsy (progression of underlying pathologies or intrinsic expression of epileptic syndromes); in these last cases, our results show a higher occurrence in cryptogenic frontal epilepsy (p = 0.01). We identified two subgroups according to the duration of the event, i.e. SE lasting 12 h. Our results showed a worse response to therapy in SE lasting >12 h (p = 0.01), a better response to therapy in non-convulsive SE than in convulsive SE (p < 0.05) and a relationship at statistical significance limit between a poor response to therapy/worse outcome and symptomatic epileptic syndromes (p = 0.06). Conclusion: SE in epileptic patients has a wide spectrum of electro-clinical features. It may be related to the withdrawal or reduction of AEDs, or may even be the expression of the evolution of epileptic syndromes. Response to therapy is dependent on early diagnosis and therapy. © 2008 British Epilepsy Association
Effectiveness of Rufinamide in the Treatment of Idiopathic Generalized Epilepsy With Atypical Evolution: Case Report and Review of the Literature.
No full textThe spectrum of epileptic syndromes with fixation off sensitivity persisting in adult life
No full textPurposeThe term fixation off sensitivity (FOS) was proposed by Panayiotopoulos to describe epilepsy/electroencephalography (EEG) changes evoked by the suppression of central vision and fixation. The EEG pattern usually consists of spike/polyspike and waves localized in occipital regions. FOS occurs mainly in children with idiopathic occipital partial epilepsies and rarely in adults. In this retrospective study we evaluated the clinical data, EEG, and magnetic resonance imaging (MRI) findings of patients with epilepsy and FOS persisting in adult life to better define the spectrum of syndromes. MethodsWe selected 15 consecutive patients (12 female/3 male; age range 19-59years). The main inclusion criterion was the diagnosis of epilepsy with FOS persisting in adult life. We retrospectively analyzed clinical EEG and neuroimaging data. Key FindingsWe observed a female prevalence (F/M=12/3). Eight patients presented both simple and complex partial seizures, whereas seven had only complex partial seizures. Partial seizures evolved into generalized seizures/hemiconvulsions in nine cases. The FOS pattern consisted of spike-and-wave and slow-wave abnormalities with posterior localization (bilateral in eight/monolateral in seven). We recorded seizures in 10/15 patients. All showed a posterior onset (bilateral in 2/left in 2/right in 6). FOS was prevalent in symptomatic epilepsy (cortical malformations in 7; celiac disease in 3; calcified vascular malformation in 1). One patient presented cryptogenic epilepsy and only three idiopathic epilepsy (Gastaut syndrome). SignificanceFOS can be observed in adult life in idiopathic epilepsy, representing the prolongation of the same phenomenon arisen during childhood. Nevertheless, it often represents the EEG expression of symptomatic epilepsies (cortical malformations/celiac disease)
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