Paradoxical ictal EEG lateralization in children with unilateral encephaloclastic lesions

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dc.contributor.author Garzon, Eliana [UNIFESP]
dc.contributor.author Gupta, Ajay
dc.contributor.author Bingaman, William
dc.contributor.author Sakamoto, Americo C. [UNIFESP]
dc.contributor.author Luders, Hans
dc.date.accessioned 2016-01-24T13:58:39Z
dc.date.available 2016-01-24T13:58:39Z
dc.date.issued 2009-09-01
dc.identifier http://dx.doi.org/10.1684/epd.2009.0264
dc.identifier.citation Epileptic Disorders. Montrouge: John Libbey Eurotext Ltd, v. 11, n. 3, p. 215-221, 2009.
dc.identifier.issn 1294-9361
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/31762
dc.description.abstract Background. Describe an ictal EEG pattern of paradoxical lateralization in children with unilateral encephaloclastic hemispheric lesion acquired early in life. Methods. of 68 children who underwent hemispherectomy during 2003-2005, scalp video-EEG and brain MRI of six children with an ictal scalp EEG pattern discordant to the clinical and imaging data were reanalyzed. Medical charts were reviewed for clinical findings and seizure outcome. Results. Age of seizure onset was 1 day-4 years. the destructive MRI lesion was an ischemic stroke in 2, a post-infectious encephalomalacia in 2, and a perinatal trauma and hemiconvulsive-hemiplegic syndrome in one patient each. Ictal EEG pattern was characterized by prominent ictal rhythms with either 3-7 Hz spike and wave complexes or beta frequency sharp waves (paroxysmal fast) over the unaffected (contralesional) hemisphere. Scalp video-EEG was discordant, however, other findings of motor deficits (hemiparesis; five severe, one mild), seizure semiology (4/6), interictal EEG abnormalities (3/6), and unilateral burden of MRI lesion guided the decision for hemispherectomy. After 12-39 months of post-surgery follow up, five of six patients were seizure free and one has brief staring spells. Conclusion. We describe a paradoxical lateralization of the EEG to the good hemisphere in children with unihemispheric encephaloclastic lesions. This EEG pattern is compatible with seizure free outcome after surgery, provided other clinical findings and tests are concordant with origin from the abnormal hemisphere. en
dc.format.extent 215-221
dc.language.iso eng
dc.publisher John Libbey Eurotext Ltd
dc.relation.ispartof Epileptic Disorders
dc.rights Acesso aberto
dc.subject epilepsy surgery en
dc.subject EEG en
dc.subject pediatric epilepsy en
dc.subject video-EEG in epilepsy en
dc.title Paradoxical ictal EEG lateralization in children with unilateral encephaloclastic lesions en
dc.type Artigo
dc.contributor.institution Cleveland Clin Fdn
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Univ Hosp Cleveland
dc.description.affiliation Cleveland Clin Fdn, Neurol Inst, Epilepsy Ctr, Cleveland, OH 44195 USA
dc.description.affiliation Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliation Univ Hosp Cleveland, Epilepsy Ctr, Cleveland, OH 44106 USA
dc.description.affiliationUnifesp Universidade Federal de São Paulo, São Paulo, Brazil
dc.identifier.doi 10.1684/epd.2009.0264
dc.description.source Web of Science
dc.identifier.wos WOS:000270687600004



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