Epileptic EEG Findings in Short-Term Memory Difficulty.
Abstract number :
1.071
Submission category :
Year :
2001
Submission ID :
1190
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
H. Hasegawa, M.D., Neurology, Aleda E. Lutz VA Medical Center, Saginaw, MI
RATIONALE: Short-term memory difficulty (STMD) is not an infrequent complaint in mature adults, particularly in elderly patients. Persistent STMD may be initial sign of Alzheimer dementia or due to acquired brain lesions, but intermittent STMD also could be epileptic phenomena.
METHODS: Patients who were referred as [dsquote]memory problem[dsquote] or [dsquote]possible dementia[dsquote] with [underline]only[/underline] clinical manifestation of STMD with no history of previous seizure disorder were serially identified in the VA outpatient neurology clinic. All cases underwent CT/MRI. Upon careful history taking, those who have intermittent STMD were separated from those who have persistent STMD. The former group underwent standard 10-20 scalp awake and asleep EEG recordings with T1-T2 electrodes.
RESULTS: There were 37 adult males but no female patients in this study. Among them, 14 patients (37.8%) had intermittent STMD. Among the 14 patients (Ages 42-87 years; average 60), only 3 patients (21.4%) had normal EEG; 1 patient had left temporal slowing, 7 patients had lateralized interictal spikes (IIS), 1 patient had bitemporal IIS, and 2 patients had left temporal electrographic seizure patterns in T1. Therefore, 10 out of 14 (71.4%) had epileptic findings in EEG. Neuroimaging study was normal in 7/14 (50%), diffuse atrophy in 3/14 (21%), and focal lesion in 4/14 (29%). Neither case of electrographic seizure had focal temporal lobe lesion by MRI study.
CONCLUSIONS: Intermittent or episodic STMD may more likely have epileptic EEG findings even though they do not have known history of seizure disorder in this study. Moreover, the study revealed two patients who have subclinical electrographic seizure pattern by EEG in inferior dominant temporal lobe while intermittent STMD is the only clinical manifestation. The findings may encourage more use of EEG studies for mature adults and for elderly patients with STMD to rule out [italic]Epileptic STMD[/italic] which may be potentially treatable with appropriate AEDs.