CLINICAL AND ELECTROENCEPHALOGRAPHIC CHARACTERISTICS OF A COHORT OF PATIENTS WITH EPILEPSY AND ABSENCE SEIZURES

CLINICAL AND ELECTROENCEPHALOGRAPHIC CHARACTERISTICS OF A COHORT OF PATIENTS WITH EPILEPSY AND ABSENCE SEIZURES

Alternative title Características clínicas e eletrencefalográficas de uma coorte de pacientes com epilepsia com crises de ausência
Author Alves-Leon, Soniza Vieira Google Scholar
Cardoso, Maria Fatima Bento de Souza Google Scholar
Pereira, Valeria Coelho Santa Rita Google Scholar
Meira, Isabella D'Andrea Autor UNIFESP Google Scholar
Institution Univ Fed Estado Rio de Janeiro UNIRIO
Universidade Federal do Rio de Janeiro (UFRJ)
Santa Casa Misericordia Rio de Janeiro
Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Epileptic syndromes with absence seizures (AS) possess unique clinical and electroencephalographic (EEG) characteristics. In typical or atypical AS, ictal phenomenology may include various characteristics. Video-EEG monitoring enables findings to be correlated with ictal phenomenology. Objective: To evaluate the different AS in a cohort of patients with drug-resistant epilepsy (DRE) based on the International League against Epilepsy (ILAE)'s 2006 classification, to correlate with ictal phenomenology recorded and to apply the Panayiotopoulos criteria. Method: This study included patients with criteria of AS followed up at the Epilepsy Clinic. A dual, cross-sectional cohort study was carried out between 2005 and 2008. Patients receiving care in the Epilepsy Program of the HUCFF-UFRJ, who had been investigated by video-EEG and who presented clinical and EEG criteria for absence seizures, typical or atypical, according to the criteria defined by the ILAE, were included in the study, independent of age onset, the review of clinical history, age onset, family history, epilepsy onset and evolution, seizures phenomenology, antiepileptic drugs response and neuroimaging studies were used to classify the patients among the different epileptic syndrome associated to absence seizures. Results: Typical absences were more frequent (71.4%) than atypical absences. Cases of juvenile absence epilepsy were the most frequent (19%) in this series, followed by childhood absence epilepsy (14.4%) and juvenile myoclonic epilepsy (4.8%). In 14 patients (66.67%), diagnosis was modified from focal epilepsy to primary generalized epilepsy. Clinical and EEG diagnosis of absence epilepsy resulted in a dramatic improvement in the control of seizures following modification of diagnosis and indication of an appropriate antiepileptic drug. Conclusion: Our results show that typical AS are more frequent than atypical. AS was successfully defined in 10 patients following application of Panayiotopoulos' criteria. The consequent change in diagnosis and therapy resulted in resolution of refractoriness in 9 patients. We concluded that in DRE, AS associated to unusual ictal phenomenology improve dramatically when diagnosed by video-EEG, permitting seizures to be controlled. Clinical and EEG evaluation confirm that myoclonus, automatisms and autonomic disorders are involved and that the consciousness may be affected to different degrees.
Keywords absence seizures
epilepsy
Panayiotopoulos
Language English
Date 2009-12-01
Published in Arquivos De Neuro-psiquiatria. Sao Paulo Sp: Assoc Arquivos Neuro- Psiquiatria, v. 67, n. 4, p. 986-994, 2009.
ISSN 0004-282X (Sherpa/Romeo, impact factor)
Publisher Assoc Arquivos Neuro- Psiquiatria
Extent 986-994
Origin http://dx.doi.org/10.1590/S0004-282X2009000600005
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000272736500005
SciELO ID S0004-282X2009000600005 (statistics in SciELO)
URI http://repositorio.unifesp.br/11600/42750

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