Epileptic spasms and partial seizures as a single ictal event
Christa Pachatz1, Lucia Fusco, Federico Vigevano
1Department of Neurology, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy. pachatz@opbg.net
Epilepsia
|May 20, 2003
Summary
Epileptic spasms (ESs) occurring with other seizure types in one event can have various causes and do not predict outcomes. While often unfavorable, the prognosis for this seizure combination is not always poor.
Area of Science:
- Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Epileptic spasms (ESs) are a distinct seizure type.
- The co-occurrence of ESs with other seizure types in a single ictal event is not well-characterized.
- Understanding this phenomenon may offer insights into epilepsy etiology and prognosis.
Purpose of the Study:
- To investigate epileptic spasms (ESs) occurring alongside other seizure types within a single ictal event.
- To determine the predictive value of this combined seizure phenomenon for epilepsy etiology and patient prognosis.
Main Methods:
- Retrospective analysis of video-electroencephalography (EEG) recordings.
- Inclusion of 13 patients (8 female, 5 male) exhibiting ESs and other seizure types in a single event.
- Classification of seizure patterns based on the temporal association between ESs and partial seizures (PSs).
Main Results:
- All associated seizures involved partial seizures (PSs).
- Three seizure patterns were identified: PS followed by ES, PS during ES clusters, and complex interactions.
- Etiologies included cortical dysplasia, cerebral malformations, and perinatal injuries; four cases were cryptogenic.
- Poor outcome (intractable epilepsy) occurred in nine patients; four had favorable outcomes.
Conclusions:
- The association of ESs and PSs in a single event has diverse etiologies and is not specific to severe brain damage.
- Observed seizure patterns do not reliably predict etiology or prognosis.
- The prognosis for patients with this phenomenon is predominantly unfavorable, but not universally so.
Related Concept Videos
01:28Integration of Synaptic Events
Synaptic integration mainly includes the summation of graded potentials. Graded potentials, regardless of their type, cause subtle alterations in membrane voltage, resulting in either depolarization or hyperpolarization. These incremental changes, when combined or summed, can propel the neuron toward its threshold. Consider, for example, a membrane experiencing a +15 mV shift, causing it to depolarize from -70 mV to -55 mV. In this scenario, graded potentials govern the membrane's ability to...
01:24Epilepsy and Seizures: Overview
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:20Seizures l: Introduction
Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
01:19Seizures ll: Types
Seizures are sudden bursts of abnormal electrical discharge in the brain that interfere with normal function. They are commonly divided into three groups: focal seizures, generalized seizures, and other types that do not fit neatly into either category.Focal SeizuresFocal seizures begin in a single brain region. When awareness is preserved, they are called focal aware seizures and may cause sensations such as tingling, unusual smells, or flashing lights. When awareness is impaired, they are...
01:22Epilepsy ll: Types
Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.