Epileptic Nystagmus

Stolz, Sarah E.; Chatrian, Gian Emilio; Spence, Alexander M.

doi:10.1111/j.1528-1157.1991.tb05550.x

Cited by 26 publications

(19 citation statements)

References 32 publications

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“…8 Nevertheless, the exact mechanisms underlying regional reductions in occipital volume remain unclear. Interestingly, in a previous study by our group, abnormal eye movements, a function that may be related to the occipital lobe, [21][22][23] were reported in 37% of the children with CBMs. 13 Unlike our previous study in ex-preterm infants with cerebellar injury 15 the current results do not show a significant volumetric difference in prefrontal and frontal regions in children with CBMs compared with healthy controls.…”

Section: Discussionmentioning

confidence: 63%

Cerebellar malformations alter regional cerebral development

Bolduc

Plessis

Evans

et al. 2011

Developmental Medicine &Amp; Child Neurology

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AIM The aim of this study was to compare total and regional cerebral volumes in children with isolated cerebellar malformations (CBMs) with those in typically developing children, and to examine the extent to which cerebellar volumetric reductions are associated with total and regional cerebral volumes. METHOD This is a case–control study of children diagnosed with isolated CBMs. Each child was matched on age and sex to two typically developing children. Using advanced three-dimensional volumetric magnetic resonance imaging, the cerebrum was segmented into tissue classes and partitioned into eight regions. Analysis of variance was used to compare cerebral volumes between children with CBMs and comparison children, and linear regressions to examine the impact of cerebellar volume reduction on cerebral volumes. RESULTS Magnetic resonance imaging was performed at a mean age of 27 months in 20 children (10 males, 10 females) with CBMs and 40 typically developing children. Children with CBMs showed significantly smaller deep grey matter nuclei (p<0.001), subgenual white matter (p=0.03), midtemporal white matter (p=0.02), and inferior occipital grey matter (p=0.03) volumes than typically developing children. Greater cerebellar volumetric reduction in children with CBMs was associated with decreased total cerebral volume and deep grey matter nuclei (p=0.02), subgenual white/grey matter (p=0.001), midtemporal white (p=0.02) and grey matter (p=0.01), and parieto-occipital grey matter (p=0.004). INTERPRETATION CBMs are associated with impaired regional cerebral growth, suggesting deactivation of principal cerebello-cerebral pathways.

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Section: Discussionmentioning

confidence: 63%

Cerebellar malformations alter regional cerebral development

Bolduc

Plessis

Evans

et al. 2011

Developmental Medicine &Amp; Child Neurology

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“…Other involuntary motor phenomena in coma are decorticate and decerebrate posturing and abnormal tonic eyelid movements and eye-opening [86,105]. They can easily be distinguished from epileptic nystagmus [142][143][144][145][146].…”

Section: Ictal Semiology In Comamentioning

confidence: 99%

Which EEG patterns in coma are nonconvulsive status epilepticus?

Trinka¹,

Leitinger²

2015

Epilepsy & Behavior

139

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Nonconvulsive status epilepticus (NCSE) is common in patients with coma with a prevalence between 5% and 48%. Patients in deep coma may exhibit epileptiform EEG patterns, such as generalized periodic spikes, and there is an ongoing debate about the relationship of these patterns and NCSE. The purposes of this review are (i) to discuss the various EEG patterns found in coma, its fluctuations, and transitions and (ii) to propose modified criteria for NCSE in coma. Classical coma patterns such as diffuse polymorphic delta activity, spindle coma, alpha/theta coma, low output voltage, or burst suppression do not reflect NCSE. Any ictal patterns with a typical spatiotemporal evolution or epileptiform discharges faster than 2.5 Hz in a comatose patient reflect nonconvulsive seizures or NCSE and should be treated. Generalized periodic diacharges or lateralized periodic discharges (GPDs/LPDs) with a frequency of less than 2.5 Hz or rhythmic discharges (RDs) faster than 0.5 Hz are the borderland of NCSE in coma. In these cases, at least one of the additional criteria is needed to diagnose NCSE (a) subtle clinical ictal phenomena, (b) typical spatiotemporal evolution, or (c) response to antiepileptic drug treatment. There is currently no consensus about how long these patterns must be present to qualify for NCSE, and the distinction from nonconvulsive seizures in patients with critical illness or in comatose patients seems arbitrary. The Salzburg Consensus Criteria for NCSE [1] have been modified according to the Standardized Terminology of the American Clinical Neurophysiology Society [2] and validated in three different cohorts, with a sensitivity of 97.2%, a specificity of 95.9%, and a diagnostic accuracy of 96.3% in patients with clinical signs of NCSE. Their diagnostic utility in different cohorts with patients in deep coma has to be studied in the future. This article is part of a Special Issue entitled "Status Epilepticus".

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“…However, reviews in the literature collecting cases of epileptic nystagmus report rates of associated episodic vertigo/dizziness of only 5%-7%. [54][55][56] This dissociation suggests that the cortical areas eliciting epileptic nystagmus and EVD are activated at the same time by an epileptic attack in only a minority of cases. If the clinician therefore witnesses a seizure presenting with EVD, it is unlikely that he or she will detect nystagmus and vice versa.…”

Section: Pulmonarymentioning

confidence: 99%

Clinical and electrographic findings in epileptic vertigo and dizziness

et al. 2015

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Objective: Seizures can cause vestibular symptoms, even without obvious epileptic features. We sought to characterize epileptic vertigo or dizziness (EVD) to improve differentiation from nonepileptic causes, particularly when vestibular symptoms are the sole manifestation. Methods:We conducted a systematic review with electronic (Medline) and manual search for English-language studies . Two independent reviewers selected studies. Study/patient characteristics were abstracted. We defined 3 study population types: (1) seizures, some experiencing vertigo/dizziness (disease cohort); (2) vertigo/dizziness, some due to seizures (symptom cohort); (3) vertigo/dizziness due to seizures in all patients (EVD-only cohort). Results:We identified 84 studies describing 11,354 patients (disease cohort 5 8,129; symptom cohort 5 2,965; EVD-only cohort 5 260). Among 1,055 EVD patients in whom a distinction could be made, non-isolated EVD was present in 8.5%, isolated EVD in 0.8%. Thorough diagnostic workups (ictal EEG, vestibular testing, and brain MRI to exclude other causes) were rare (,0.1%). Ictal EEG was reported in 487 (4.3%), formal neuro-otologic assessment in 1,107 (9.7%). Localized EEG abnormalities (n 5 350) were most frequently temporal (79.8%) and uncommonly parietal (11.8%). Duration of episodic vestibular symptoms varied, but was very brief (,30 seconds) in 69.6% of isolated EVD and 6.9% of non-isolated EVD.Conclusions: Non-isolated EVD is much more prevalent than isolated EVD, which appears to be rare.Diagnostic evaluations for EVD are often incomplete. EVD is primarily associated with temporal lobe seizures; whether this reflects greater epidemiologic prevalence of temporal lobe seizures or a tighter association with dizziness/vertigo presentations than with other brain regions remains unknown. Consistent with clinical wisdom, isolated EVD spells often last just seconds, although many patients experience longer spells. Neurology ® 2015;84:1595-1604 GLOSSARY AED 5 antiepileptic drug; EVD 5 epileptic vertigo or dizziness; i-EVD 5 isolated epileptic vertigo or dizziness; ni-EVD 5 nonisolated epileptic vertigo or dizziness.

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Epileptic Nystagmus

Cited by 26 publications

References 32 publications

Cerebellar malformations alter regional cerebral development

Cerebellar malformations alter regional cerebral development

Which EEG patterns in coma are nonconvulsive status epilepticus?

Clinical and electrographic findings in epileptic vertigo and dizziness

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