SEIZURE SEMIOLOGY IN TEMPORAL LOBE EPILEPSY: HIPPOCAMPAL SCLEROSIS VERSUS HIPPOCAMPAL SCLEROSIS PLUS
Abstract number :
2.079
Submission category :
Year :
2002
Submission ID :
1579
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Brenda Giagante, Walter Horacio Silva, Damian Cosalvo, Silvia Andrea Oddo, Patricia Solis, Estela Centurion, Pablo Salgado, Patricia Saidon, Silvia Sara Kochen. Epilepsy Center, Department of Neurology, Ramos Mej[iacute]a Hospital, Buenos Aires, Buenos Ai
RATIONALE: At the end of this activity the participants should be able to discuss if patients with pure hippocampal sclerosis (HS), and patients with HS associated with abnormalities on the temporal pole belong to different subgroups.
To compare ictal and postictal clinical symptoms in patients with temporal lobe epilepsy (TLE) and pure hippocampal sclerosis (HS), and patients with TLE and HS associated with abnormalities on the temporal pole (HS-Plus), diagnosed by magnetic resonance imaging.
METHODS: Blinded to clinical details, we reviewed preoperative ictal video-EEG recordings from patients with TLE and HS, and from patients with TLE and HS-plus, who underwent temporal lobectomy. We analyzed ictal and postictal symptoms, and the order of appearance of the manifestations in the first 30 seconds of the seizures.
RESULTS: We analyzed 56 seizures in 21 patients. Patients were differentiated in 2 groups: group 1- HS (16 patients, 36 seizures); and group 2- HS-plus (5 patients, 20 seizures). The most frequent auras were: patients group 1: epigastric sensation (50%) and fear (25%), and patients group 2: epigastric sensation (40%), fear (40%) and [dsquote]deja vu[dsquote] (40%). The most frequent clinical symptoms were: patients group 1: staring (88%), behavioral arrest (86%), oroalimentary automatisms (72%), repetitive hand automatisms (67%); and patients group 2: oroalimentary automatisms (65%), repetitive hand automatisms (55%), staring (45%). The symptom [dsquote]deja vu[dsquote] was more frequent in group 2 (p[lt]0.001), and the clinical manifestation [dsquote]behavioral arrest[dsquote] was more frequent in group 1 (p[lt]0.001). The most common sequence of symptoms in group 1 was behavioral arrest - staring - oroalimentary automatisms - repetitive hand automatisms; we do not found any specific sequence of symptoms in group 2 (p [lt]0.001).
CONCLUSIONS: These observations suggests that patients with HS and HS-plus belong to different subgroups of patients. The presence of a specific sequence of symptoms may be useful in discriminating seizures of pure HS from HS-plus seizures.
[Supported by: Epilepsy Center, Department of Neurology, Ramos Mej[iacute]a Hospital]