Focal Status Epilepticus: Modern Concepts

Delgado‐Escueta, Antonio V.; Treiman, David M.

doi:10.1007/978-1-4471-1401-7_14

Cited by 11 publications

(5 citation statements)

References 83 publications

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“…[ 33 ] During sleep, the EEG may display runs of fast polyspikes, that, when prolonged, may correspond to tonic seizures; clinically, these patients often suffer from seizures complicated by sudden and abrupt falls to the ground. [ 34 ] The ictal EEG patterns are mostly bilateral, symmetrical, and synchronous. [ 35 ] contrary to this, the current study identified FSWSBS as the most associated ictal pattern in study patients, though a careful effort was done to differentiate FSWSBS from regional spike-wave discharges from a treated generalized epilepsy EEG findings.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Activation and Appearances of Epileptiform Abnormalities in Routine Electroencephalography by Different Provocation Methods

Nazish

2024

Annals of African Medicine

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Objective: The objective of this study was to observe the effects of various clinical factors on the activation and appearance of epileptiform abnormalities (EAs) in routine electroencephalography (rEEG) by different provocation methods. Methods: This observational study involved a review of 136 patients presented for EEG recording due to various indications and their EEG showing EAs during various provocation methods. Results: Generalized spike-wave discharges (GSWDs) were the most frequent activated epileptiform pattern observed in, 81 (59.1%) recordings. This pattern was seen mainly in females 49 (P = 0.00), in patients with generalized seizures 48 (P = 0.00), in prolonged EEG records 3 (P = 0.03), and in both genetic 35 (P = 0.00) and lesional epilepsies 21 (P = 0.00). Focal sharp waves with bilateral synchrony (FSWSBS) were the most activated ictal pattern (P = 0.00). Ictal EAs after hyperventilation (HV) (P = 0.03) and intermittent photic stimulation (IPS) (P = 0.01) were mainly observed in patients with uncontrolled seizures (P = 0.00), and immune-mediated epilepsy (P = 0.02). Females sex (odds ratio [OR]: 1.33, confidence interval [CI]: 0.6–2.6; P = 0.25), bilateral tonic–clonic seizures (OR: 1.17, CI: 0.5–2.4; P = 0.31) and lesional epilepsies (OR: 1.45, CI: 0.7–2.9; P = 0.20) had risk of activation of EAs by provocation methods; however this risk was not statistically significant. While sleep deprivation (SD) (OR: 6.33, CI: 2.2–18.2; P = 0.00), nonrapid eye movement sleep (NREM) (OR: 2.41, CI: 1.0–5.4; P = 0.00), and prolong EEG recording (OR: 1.91, CI: 0.9–3.9; P = 0.04) were leading to a statistically significant risk of activation and appearances of EAs due to provocation. Conclusion: Different provocation methods can activate and augment the variety of EEG patterns of diverse clinical significance. Detection of activated ictal EAs is dependent on various patient factors, including seizure control, and the provocation method applied. Further larger prospective cohort studies with adequate sample sizes are warranted.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting the Activation and Appearances of Epileptiform Abnormalities in Routine Electroencephalography by Different Provocation Methods

Nazish

2024

Annals of African Medicine

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Section: Complex Partial Status Epilepticusmentioning

confidence: 98%

“…(Gastaut and Tassinari 1975) These two presentations probably represent a continuum in a spectrum of electroclinical changes that approximate, albeit in a much milder way, to those of generalized convulsive status epilepticus (GCSE) described by Treiman et al 1990. A frequent, but not essential, clinical feature of CPSE is cycling between a continuous twilight state with partial and amnestic responsiveness and an arrest reaction with motionless stare, complete unresponsiveness and stereotyped automatisms, Delgado-Escueta 1983,Delgado-Escueta andTreiman 1987). Diagnosis of CPSE is based on a clinical presentation of a confusional state (sometimes punctuated by periods of less responsiveness and stereotyped automatisms), an ictal EEG with focal discharges like those of isolated CP seizures on an abnormal background, prompt response of the behavior and EEG to intravenous AEDs, and an interictal epileptifom focus in one or more temporal or frontal lobes.…”

Section: David Treimanmentioning

confidence: 99%

“…We now recognize CPSE as the epileptic twilight confusional state caused by prolonged focal epileptic discharges from temporal or extratemporal regions of the brain. Although once considered rare, there was an explosion of interest in this entity starting about 20 years ago, perhaps due to the advent of CCTV/EEG epilepsy monitoring (Delgado‐Escueta and Treiman 1987) and by 1990 more than 200 cases had been reported. Current thinking is that CPSE may account for as many as one quarter of all episodes of SE.…”

Section: Complex Partial Status Epilepticusmentioning

confidence: 99%

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Nonconvulsive status epilepticus: Epilepsy Research Foundation Workshop Reports

Walker,

Cross,

Smith

et al. 2005

Epileptic Disorders

108

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In April 2004, a group of physicians with an interest in nonconvulsive status epilepticus representing a spectrum of opinion met in Oxford, sponsored by the Epilepsy Research Foundation (a charitable organization), to discuss and debate the definition, diagnosis and treatment of nonconvulsive status epilepticus. We felt that such a meeting would be useful, as nonconvulsive status epilepticus is a subject that provokes strong reactions, perhaps largely due to the relative lack of evidence and the surfeit of opinion. The meeting was arranged such that there were formal talks followed by a discussion led by one of the attendees. We present here the extended abstracts of the main talks with the points raised by the discussants. Despite disagreements on certain issues there was much in the way of consensus. First, it was agreed that nonconvulsive status epilepticus is a term that covers a range of disparate conditions with varying prognoses and treatments. The agreed definition was thus suitably vague, «Nonconvulsive status epilepticus is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in nonconvulsive clinical symptoms». Secondly, it was agreed that even within a specific condition ( e.g. complex partial status epilepticus), the prognosis and treatment depends upon the context in which the condition occurs ( e.g. in the critically ill, in coma, in the «walking wounded» and in people with prior epilepsy). Perhaps, most importantly it was agreed that we lacked good clinical data, and the challenge was to design good studies for a condition that is underrecognised and often difficult to diagnose.

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“…Partial seizures with preserved consciousness are called SPSE when continuous clinical and EEG seizures are present for at least 30 minutes. 2 In general neurological practice two groups of patients with SPSE are encountered most often:…”

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confidence: 99%