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Ictal amaurosis: MRI, EEG, and clinical features
1Section of Epilepsy and Clinical Neurophysiology, Cleveland Clinic Foundation, OH, USA.
Neurology
|August 1, 1995
Summary
Seizures causing temporary blindness (amaurosis) may indicate underlying brain lesions, not always benign epilepsy. Magnetic resonance imaging (MRI) is recommended for patients without a family history of similar seizures.
Area of Science:
- Neurology
- Epileptology
- Neuroimaging
Background:
- Amaurosis (temporary blindness) can be a prominent seizure symptom.
- Distinguishing between benign and lesional epilepsy is crucial for patient management.
Purpose of the Study:
- To investigate the characteristics of epilepsy presenting with ictal amaurosis.
- To determine the role of neuroimaging in identifying underlying brain lesions in such cases.
Main Methods:
- Retrospective study of seven consecutive patients with amaurosis as a key seizure feature.
- Analysis of clinical presentation, electroencephalography (EEG), and magnetic resonance imaging (MRI) findings.
- Comparison with previously reported cases of benign occipital lobe epilepsy.
Main Results:
- Mean age of seizure onset was 4 years.
- Six of seven patients had MRI abnormalities (ischemic, traumatic, space-occupying lesions), often in the parietal-occipital region.
- Six patients showed unilateral, posterior interictal spikes; four experienced severe postictal headache and nausea.
Conclusions:
- Ictal amaurosis, occipital paroxysms, and postictal migrainous symptoms do not always indicate benign epilepsy.
- The presence of MRI lesions, particularly in the absence of a family history, warrants further investigation.
- MRI is recommended for patients presenting with these seizure characteristics and no family history of epilepsy.