Abstracts

Sensory simple partial seizures (SSPS) were extensively studied as auras preceding complex partial (CPS) and secondarily generalized seizures (GS). However, they have not been well characterized in epilepsy patients presenting with these seizures as the predominant or only type. The objective of this study is to describe our experience with this particular group of patients., The adult epilepsy database was searched for patients diagnosed with SSPS, excluding the ones with current CPS or GS. The epileptic nature of the spells had to be supported by EEG and/or the presence of a compatible epileptogenic lesion on brain MRI. We examined whether these patients had other seizure types (CPS or GS) in the past and determined the distribution of epileptic foci between the two cerebral hemispheres. In those patients who had never experienced CPS or GS, we determined the interval between onset of symptoms and their correct characterization as epileptic., Twenty one patients, nine men and 12 women, were selected. Their age ranged from 25 to 79 years. Three (14%) were included just based on the presence of clear ictal and/or interictal epileptiform discharges on EEG, nine (43%) had appropriate epileptogenic lesions on brain MRI, and the remaining nine (43%) had combined EEG and MRI abnormalities. Twelve subjects (57%) had never experienced other seizure types, while nine (43%) reported rare GS/CPS in the past. The epileptogenic focus lateralized to the right cerebral hemisphere in 15 patients (71%) and to the left in six (29%), p=0.08. In the subjects with no history of GS or CPS, the delay to the correct diagnosis ranged from three weeks to five years (mean=16 months), with seven of the 12 patients waiting for more than one year to be adequately diagnosed and treated., Practitioners should be aware of the potential for SSPS to occur as the exclusive or main seizure type in some epilepsy patients. The appropriate work up, diagnosis and treatment are often delayed in such circumstances. In addition, we noted a trend suggesting that right hemispheric foci are overrepresented in this particular population.,