Eyelid Myoclonia with Absences in Adults: A Clinical and Video‐EEG Study

Giannakodimos, S.; Panayiotopoulos, C. P.

doi:10.1111/j.1528-1157.1996.tb00509.x

Cited by 99 publications

(141 citation statements)

References 10 publications

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“…tion according to the criteria proposed by Panayiotopoulos et al 1,5 According to Panayiotopoulos 2 , the classification of a specific syndrome is in agreement with the literature when application of the criteria used results in an increase in that classification category and a consequent improvement in the therapeutic options available to the respective patients 1,5,24,30 . We attribute the large rate of cases of phantom absences in this series to the fact that these patients had seizures that were difficult to diagnose, this type of referral being commonplace at specialized centers.…”

supporting

confidence: 58%

Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

Alves-Leon

Cardoso

Pereira³

et al. 2009

Arq. Neuro-Psiquiatr.

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-Background: Epileptic syndromes with absence seizures (AS) possess unique clinical and electroencephalographic (EEG) characteristics. In typical or atypical AS, ictal phenomenology may include various characteristics. Vídeo-EEG monitoring enables findings to be correlated with ictal phenomenology. Objective: To evaluate the different AS in a cohort of patients with drug-resistant epilepsy (DRE) based on the International League against Epilepsy (ILAE)'s 2006 classification, to correlate with ictal phenomenology recorded and to apply the Panayiotopoulos criteria. Method: This study included patients with criteria of AS followed up at the Epilepsy Clinic. A dual, cross-sectional cohort study was carried out between 2005 and 2008. Patients receiving care in the Epilepsy Program of the HUCFF-UFRJ, who had been investigated by video-EEG and who presented clinical and EEG criteria for absence seizures, typical or atypical, according to the criteria defined by the ILAE, were included in the study, independent of age onset, the review of clinical history, age onset, family history, epilepsy onset and evolution, seizures phenomenology, antiepileptic drugs response and neuroimaging studies were used to classify the patients among the different epileptic syndrome associated to absence seizures. Results: Typical absences were more frequent (71.4%) than atypical absences. Cases of juvenile absence epilepsy were the most frequent (19%) in this series, followed by childhood absence epilepsy (14.4%) and juvenile myoclonic epilepsy (4.8%). In 14 patients (66.67%), diagnosis was modified from focal epilepsy to primary generalized epilepsy. Clinical and EEG diagnosis of absence epilepsy resulted in a dramatic improvement in the control of seizures following modification of diagnosis and indication of an appropriate antiepileptic drug. Conclusion: Our results show that typical AS are more frequent than atypical. AS was successfully defined in 10 patients following application of Panayiotopoulos' criteria. The consequent change in diagnosis and therapy resulted in resolution of refractoriness in 9 patients. We concluded that in DRE, AS associated to unusual ictal phenomenology improve dramatically when diagnosed by video-EEG, permitting seizures to be controlled. Clinical and EEG evaluation confirm that myoclonus, automatisms and autonomic disorders are involved and that the consciousness may be affected to different degrees.

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supporting

confidence: 58%

Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

Alves-Leon

Cardoso

Pereira³

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Despite the opposing characteristics between photosensitivity and FOS, there is a case report of conversion from one to another (5). We also reported a patient with eyelid myoclonia with absences, a predominantly photosensitive syndrome with both eye-closure (attenuated in darkness) and eyes-closed (activated in darkness) EEG abnormalities (6).…”

Section: Photosensitivity Is Enhanced When Intermittentmentioning

confidence: 89%

Fixation‐Off (Scoto) Sensitivity Combined with Photosensitivity

1998

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Summary: A 16-year-old boy of normal intelligence had brief absence and myoclonic jerks since age 7 years. Video-EEG documented the unexpected combination of fixation-off sensitivity (scotosensitivity) with photosensitivity. Key Words: Fixation-off sensitive epilepsy-Scotosensitive epilepsyPhotosensitive epilepsy.Photosensitivity with seizures or electroencephalographic (EEG) abnormalities or both elicited by light is the commonest form of precipitation amongst reflex epilepsies, and it is routinely tested in EEG departments. Conversely, scotosensitivity is considered a rare form of provocation, with seizures or EEG abnormalities elicited by darkness (1). However, the excitatory effect of darkness in scotosensitivity is due to the elimination of central vision and fixation, and darkness is not a prerequisite for the epileptogenic activation ( 1 4 ) . Therefore, the term fixation-off sensitivity (FOS) is more appropriate than scotosensitivity for the forms of epilepsy, EEG abnormalities, or both that are elicited by elimination of central vision and fixation (14). Genuine cases of scotosensitivity may exist, but their documentation would require exclusion of FOS (lj.Photosensitivity appears to have mechanisms opposite those of FOS (1 j:1. The resting EEG of photosensitive patients frequently shows abnormalities on eye-closure that are inhibited by total darkness and often by the elimination of central vision and fixation. Conversely, in FOS, the EEG abnormalities are constantly associated and persist for as long as the eyes are closed, and they are activated by total darkness and elimination of central vision and fixation. 2. Photosensitivity is mediated mainly through central vision and fixation, whereas FOS is activated by the elimination of central vision and fixation, such as vision through +10 spherical lenses, underwater goggles covered with semitransparent tape, Frenzel

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“…Despite the sensitivity of the absences to antiepileptic drugs, the eyelid myoclonia often persists, as seen in our patient. 4 A small proportion of patients may continue to have uncontrolled generalized convulsions. 4 Valproic acid, lamotrigine, and levetiracetam are good treatment options, 1,5 whereas sodium channel agents such as carbamazepine may exacerbate the seizures.…”

mentioning

confidence: 99%

“…4 A small proportion of patients may continue to have uncontrolled generalized convulsions. 4 Valproic acid, lamotrigine, and levetiracetam are good treatment options, 1,5 whereas sodium channel agents such as carbamazepine may exacerbate the seizures. 6 Our patient initially responded to valproic acid, but he developed a reaction concerning for StevensJohnson syndrome.…”

mentioning

confidence: 99%

“…1,3 The photosensitivity component may decrease as the patients get older. 1,4 Classic EEG features include a sharply contoured or spiky alpha frequency activity that rapidly spreads to the frontal regions with sustained eye closure. Eyelid myoclonia often coincides as well with occipital epileptic discharges or occipital polyspike and wave discharges, with or without generalized polyspike and wave discharges.…”

mentioning

confidence: 99%

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