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Hemispheric epilepsy

W T Blume1

  • 1London Health Sciences Centre-University Campus, The University of Western Ontario, Canada.

Brain : a Journal of Neurology
|November 3, 1998
PubMed
Summary
This summary is machine-generated.

This study identifies a new syndrome of hemispheric epilepsy characterized by consistent unilateral EEG abnormalities, intractable seizures starting in youth, and no clear cause. This epilepsy impacts brain function and requires ongoing management.

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Area of Science:

  • Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Epilepsy diagnosis relies heavily on electroencephalogram (EEG) and clinical presentation.
  • Unilateral EEG abnormalities can indicate focal or generalized epilepsy syndromes.
  • Longitudinal studies are crucial for understanding epilepsy progression and characteristics.

Purpose of the Study:

  • To document the clinical and EEG features of a specific epilepsy syndrome.
  • To characterize patients with consistent unilateral interictal spike-waves.
  • To define the components of this newly identified hemispheric epilepsy syndrome.

Main Methods:

  • Retrospective analysis of 13 patients with consistent unilateral EEG abnormalities.
  • Selection from a large database (25,000 patients) over 25 years.

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  • Review of clinical history, EEG recordings, seizure types, and follow-up data.

    • Main Results:

    • 13 patients exhibited consistent unilateral spike-waves, predominantly over the left hemisphere (62%).
    • Seizures began in childhood/adolescence, were often intractable (85% continued to have seizures), and frequently presented with generalized ictal features.
    • No clear etiology or structural brain abnormality was identified in any patient; 85% had normal intelligence.

    Conclusions:

    • A novel syndrome of hemispheric epilepsy is described, defined by unilateral EEG spike-waves, intractable seizures, childhood/adolescent onset, and idiopathic nature.
    • This syndrome presents with diffuse unilateral spike-waves, persistent seizures with generalized ictal features, and lacks identifiable structural causes.
    • Further research is needed to understand the pathophysiology and optimize treatment for this distinct epilepsy syndrome.