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05:54
Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
Published on: June 13, 2016
Orienting reaction in therapy-resistant generalized epilepsy
R Rogozea1, V Florea-Ciocoiu, D Haţegan
1Institute of Neurology and Psychiatry, Bucharest, Romania.
Romanian Journal of Neurology and Psychiatry = Revue Roumaine De Neurologie Et Psychiatrie
|July 1, 1990
Summary
Epilepsy patients with therapy-resistant generalized seizures exhibit heightened orienting reactions. Antiepileptic drug treatment can improve these interictal responsiveness disturbances, suggesting nervous system excitability issues.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychophysiology
Background:
- Epilepsy is characterized by recurrent seizures, often associated with altered nervous system excitability.
- Understanding interictal (between seizures) physiological responses is crucial for managing therapy-resistant generalized seizures (TRGS).
Purpose of the Study:
- To investigate the orienting reaction components in individuals with TRGS compared to control groups.
- To identify factors influencing responsiveness disturbances in TRGS patients.
- To evaluate the impact of antiepileptic treatment on interictal responsiveness.
Main Methods:
- Polygraphic recordings of somatic, autonomic, and EEG responses to auditory stimuli.
- Comparison of 39 TRGS patients with two control groups (119 subjects total).
- Correlation and multivariate regression analyses to determine predictive variables for responsiveness disturbances.
Main Results:
- Epileptics with TRGS showed significantly heightened orienting reactions compared to normal subjects and therapy-controlled epilepsy patients.
- Responsiveness disturbances correlated with patient age, seizure type, pretrial seizure frequency, EEG type, and antiepileptic drug regimen (number, dose, serum level).
- Multivariate analysis identified pretrial seizure frequency, seizure type, drug dose, and serum level as key predictors.
Conclusions:
- Therapy-resistant generalized seizures are associated with interictal hyperresponsivity, likely due to nervous system excitability disturbances.
- Antiepileptic treatment demonstrates a positive effect on these responsiveness disturbances, with sustained treatment yielding greater improvement.
- These findings highlight the potential for targeting excitability modulation in epilepsy management.
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