Ethosuximide-Induced Conversion of Typical Childhood Absence to Rolandic Spikes

Anyanwu, Chinekwu; Ghavami, Forough; Schuelein, Marianne; Motamedi, Gholam K.

doi:10.1177/0883073812439250

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…Despite similarities of age-dependent occurrence, absence of significant lesion on neuroimaging, multifactorial etiology, genetic predisposition, and favorable long-term outcome, they are distinct electroclinical entities that rarely overlap in the same individual. [10][11][12][13] Our study reaffirmed this as over 25 years, only 0.04% of our patients had childhood and juvenile absence epilepsy and rolandic spikes. The rarity of the coexistence of these 2 EEG findings suggests a separate pathophysiology and genetic susceptibility.…”

Section: Discussionsupporting

confidence: 86%

“…9 There are few reported cases in the literature of childhood and juvenile absence epilepsy with rolandic spikes. [10][11][12][13][14] As the presence of both findings is extremely rare, distinct pathophysiological mechanisms are likely. Our objective was to compare the clinical features of patients with childhood and juvenile absence epilepsy with and without rolandic spikes, to determine if the additional feature of rolandic spikes has any clinical significance.…”

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confidence: 99%

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Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy

et al. 2019

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Purpose: Absence epilepsy and benign epilepsy of childhood with central temporal spikes are common childhood epilepsy syndromes. Although 3-Hz generalized spike-wave discharges are almost always associated with absence seizures, rolandic spikes can be present in individuals without rolandic seizures. The co-occurrence of 3-Hz generalized spike-wave and rolandic spikes is very rare. Our objective was to compare clinical features of patients with absence epilepsy with and without rolandic spikes, to determine if the additional feature of rolandic spikes has any clinical significance. Methods: Clinical information of 17 children with absence epilepsy and rolandic spikes was compared to an age-matched control group of 90 children with absence epilepsy. Results: Although most patients had excellent seizure control at follow-up, epilepsy comorbidities (cognitive and emotional problems) were observed. Comparing study vs control groups, there was no difference with anxiety (2 [11.8%] vs 8 [9%]), behavioral issues (4 [23.5%] vs 10 [11%]), mood disorders (0 vs 2 [2%]), and attention-deficit hyperactivity disorder (4 [24%] vs 10 [11%]). Significant differences were also observed: more global-developmental (5 [29%] vs 5 [6%], P < .009) and expressive-language (4 [24%] vs 5 [6%], P < .034) delay and more difficulties with school performance (11 [65%] vs 32 [36%], P < .025), especially with language-related tasks (6 [35%] vs 5 [6%], P < .001). Conclusion: Our results confirm the presence of additional epilepsy comorbidities in patients with absence epilepsy when rolandic spikes are present. Rolandic spikes in patients with absence epilepsy may be a marker of additional cognitive challenges that physicians should be aware of.

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Section: Discussionsupporting

confidence: 86%

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confidence: 99%

Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy

et al. 2019

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“…In our study and in the literature, incidental rolandic spikes in patients with absence epilepsy were the most common finding in those with both types of EEG findings. We had 17 such patients and an additional 12 are collectively reported in the literature 16 , 19 , 25 , 26 . In general, typical rolandic discharges are seen in 0.7% of awake recordings or normal children without a history of seizures; 5 if recordings had sleep, this number may be higher.…”

Section: Discussionmentioning

confidence: 96%

“…We had 17 such patients and an additional 12 are collectively reported in the literature. 16,19,25,26 In general, typical rolandic discharges are seen in 0.7% of awake recordings or normal children without a history of seizures; 5 if recordings had sleep, this number may be higher. The percentage of children with rolandic discharge who develop clinically apparent seizures is unclear.…”

Section: Discussionmentioning

confidence: 99%

Co-existence of Rolandic and 3 Hz Spike-Wave Discharges on EEG in Children with Epilepsy

Datta

Wallbank

Wong

2018

Can. J. Neurol. Sci.

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ObjectiveBenign epilepsy of childhood with central temporal spikes (BECTS) and absence epilepsy are common epilepsy syndromes in children with similar age of onset and favorable prognosis. However, the co-existence of the electrocardiogram (EEG) findings of rolandic spike and 3 Hz generalized spike-wave (GSW) discharges is extremely rare, with few cases reported in the literature. Our objective was to characterize the EEG findings of these syndromes in children in our center and review the electro-clinical features.MethodsAll EEGs at BC Children’s Hospital are entered in a database, which include EEG findings and clinical data. Patients with both centro-temporal spikes and 3 Hz GSW discharges were identified from the database and clinical data were reviewed.ResultsAmong the 43,061 patients in the database from 1992 to 2017, 1426 with isolated rolandic discharges and 528 patients with isolated 3 Hz GSW discharges were identified, and 20 (0.05%) patients had both findings: 3/20 had BECTS, and subsequently developed childhood absence epilepsy and 17/20 had no seizures characteristic for BECTS. At follow-up, 17 (85%) were seizure-free, 1 (5%) had rare, and 2 (10%) had frequent seizures.ConclusionsThis is the largest reported group of patients to our knowledge with the co-existence of rolandic and 3 Hz GSW discharges on EEGs in one institution, not drug-induced. As the presence of both findings is extremely rare, distinct pathophysiological mechanisms are likely. The majority had excellent seizure control at follow-up, similar to what would be expected for each type of epilepsy alone.

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“…ДЭПД на ЭЭГ описаны при различных синдромах идиопатической генерализованной эпилепсии; чаще всего они встречаются при детской абсансной эпилепсии, реже -при юношеской миоклонической эпилепсии [15,27,32,35]. ДЭПД и генерализованные пик-волновые паттерны нередко сосуществуют вместе при таких синдромах, как ИФЭ с псевдогенерализованными приступами и синдром Дживонса [13,18].…”

Section: Ch I Ld Neurology R U S S I a N J O U R N A L O Funclassified

Benign epileptiform discharges of childhood and associated conditions

Мухин¹

2018

Rus. ž. det. nevrol.

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This article provides a detailed description of benign epileptiform discharges of childhood (BEDC) as one of electroencephalography patterns in children. We emphasize that BEDC are not specific for both idiopathic (genetic) focal epilepsy and epilepsy in general. BEDC can be observed in a number of various disorders and also in neurologically healthy children. We developed a detailed classification of BEDC-associated states that are divided into 3 groups: neurologically healthy children, children with various forms of epilepsy, and patients with various neurological disorders without epilepsy. We found that there are 2 main factors responsible for BEDC in electroencephalogram: genetic predisposition and white matter lesions, usually occurring during the antenatal or perinatal period. BEDC should be considered rather a manifestation of congenital abnormalities in brain maturation than a marker of epilepsy. We also discuss the need for therapy in patients with BEDC-associated states.

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Ethosuximide-Induced Conversion of Typical Childhood Absence to Rolandic Spikes

Cited by 7 publications

References 7 publications

Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy

Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy

Co-existence of Rolandic and 3 Hz Spike-Wave Discharges on EEG in Children with Epilepsy

Benign epileptiform discharges of childhood and associated conditions

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