Epilepsy Secondary to Encephalomalacia Is Electrographically Distinct from Epilepsy Secondary to Malformations of Cortical Development in Adults
Abstract number :
1.128
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2023
Submission ID :
183
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Melody Trudgen, – University of Pittsburgh School of Medicine
Brenna McKaig, BS – University of Pittsburgh School of Medicine; James Castellano, MD, PhD – UPMC
Rationale: Epilepsy is a neurologic condition characterized by recurrent seizures due to abnormal, hypersynchronized brain activity. One well-studied epilepsy etiology is malformations of cortical development (MCD), which include defects in neuronal migration and differentiation during development. Less understood, however, is epilepsy secondary to post-developmental causes – including traumatic brain injury, cerebral infarction, and infection. Such insults can result in the development of encephalomalacia and focal epilepsy in susceptible individuals. We hypothesize that epilepsy secondary to post-developmental insults resulting in encephalomalacia will display longer and more frequent seizures compared to epilepsy secondary to cortical malformations. Our primary characteristics of interest are average seizure duration and frequency.
Methods: We performed a retrospective chart review of adult patients admitted to the Epilepsy Monitoring Unit (EMU) from 2019 to present day (2023) for pre-surgical evaluation of pharmacoresistant epilepsy. We identified 36 patients with epilepsy secondary to adult-onset injuries resulting in encephalomalacia and 37 patients with epilepsy secondary to MCD. In each patient, we examined the average duration and frequency of seizures, both during the first 24 hours and during the entire length of their stay in the EMU. We recorded data from 1,071 seizures in total.
Results: The average duration of seizures was significantly higher (p=0.0002) in patients with epilepsy secondary to encephalomalacia (161.33 s) compared to patients with epilepsy secondary to malformations of cortical development (67.37 s). There was no significant difference in average seizure frequency.
Conclusions: Adult patients with epilepsy secondary to post-developmental insults resulting in encephalomalacia have longer seizures on average than patients with epilepsy secondary to malformations of cortical development. This novel finding not only informs the basic pathobiology of these conditions but also may inform clinical management.
Funding: University of Pittsburgh School of Medicine Dean’s Summer Research Award
Neurophysiology