Plantar responses after epileptic seizures

Area of Science:

• Neurology
• Epilepsy Research
• Clinical Neurophysiology

Background:

• Plantar responses are neurological reflexes assessed during clinical examinations.
• Differentiating between epileptic and psychogenic seizures is crucial for accurate diagnosis and treatment.
• The diagnostic utility of plantar responses in distinguishing seizure types requires further investigation.

Purpose of the Study:

• To evaluate the occurrence and characteristics of extensor plantar responses (EPRs) following epileptic and psychogenic seizures.
• To determine if EPRs can serve as a reliable indicator for epileptic seizures.
• To investigate the lateralization of unilateral EPRs in relation to seizure onset.

Main Methods:

• Video-electroencephalography (EEG) monitoring was used to record seizures in 53 patients.
• Plantar responses were systematically assessed after 75 epileptic seizures and 21 psychogenic seizures.
• Data on the presence, type (unilateral/bilateral), and lateralization of EPRs were collected and analyzed.

Main Results:

• Extensor plantar responses (EPRs) were observed after 27% of all epileptic seizures.
• EPRs occurred in 42% of patients diagnosed with epilepsy.
• No EPRs were detected after psychogenic seizures; however, they were present in 52% of tonic-clonic seizures. Unilateral EPRs were typically contralateral to the seizure's side of onset.

Conclusions:

• Extensor plantar responses are significantly associated with epileptic seizures, particularly tonic-clonic seizures.
• The absence of EPRs following psychogenic seizures suggests their potential value in differential diagnosis.
• The contralateral lateralization of unilateral EPRs may provide lateralizing information regarding the epileptic focus.