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Synthèse
Reflex epilepsy and reflex seizures of the visual system: a clinical review
Benjamin G. Zifkin, Dorothée Kasteleijn-Nolst Trenité
and on how stimulation is performed: abnormalities are commonest in children and adolescents, especially girls. Only generalised paroxysmal epileptiform discharges are clearly linked to epilepsy. Abnormal responses may occur in asymptomatic subjects, especially children. Photosensitivity has an important genetic component. Some patients are sensitive to patterns, suggesting an occipital trigger for these events. Myoclonus and generalised convulsive and nonconvulsive seizures may be triggered by visual stimuli. Partial seizures occur less often and can be confused with migraine. Although usually idiopathic, photosensitive epilepsy may occur in degenerative diseases and some patients with photosensitive partial seizures have brain lesions. Sunlight and video screens, including television, video games, and computer displays, are the commonest environmental triggers of photosensitive seizures. Outbreaks of triggered seizures have occurred when certain flashing or patterned images have been broadcast. There are regulations to prevent this in some countries only. Pure photosensitive epilepsy has a good prognosis. There is a role for treatment with and without antiepileptic drugs, but photosensitivity usually does not disappear spontaneously, and then typically in the third decade.
Articles originaux
Cortical silent period following transcranial magnetic stimulation in epileptic patients
Nalan Kayrak Ertas, Günay Gül, Ahmet Altunhalka, Dursun Kirbas
patients with or without treatment. The aim of this study was to evaluate the effect of both the epilepsy and the antiepileptic medication on these inhibitory mechanisms. The subgroups studied consisted of (a) normal subjects, (b) unmedicated epileptic patients, (c) epileptic patients with uncontrolled seizures under medication, (d) epileptic patients with controlled seizures under medication. SP following transcranial magnetic stimulation was measured in all subjects. The SP values from shortest to the longest were in the following order: 1) normal subjects; 2) epileptic patients with controlled seizures under medication; 3) unmedicated epileptic patients; 4) epileptic patients with uncontrolled seizures under medication. Our findings probably indicate the enhanced interictal inhibitory mechanisms in epilepsy which is resistant to antiepileptic medication.
Mesial temporal lobe epilepsy versus amygdalar epilepsy: late seizure recurrence after initially successful amygdalotomy and regained seizure control following hippocampectomy
Heinz Gregor Wieser
seizure onset, associated with fear and vegetative autonomic signs and symptoms as the most prominent clinical ictal features. Following a right stereotactic amygdalotomy, the patient experienced an 11-year seizure-free period. Similar, but not identical, semeiology of complex partial seizures then recurred. A right-sided selective hippocampectomy and excision of the previously lesioned amygdala was performed. Except for 2 complex partial seizures associated with withdrawal of antiepileptic drugs, the patient remained seizure-free 9.5 years.
This case underscores the important role of the amygdala in generating the semiology, and raises several questions concerning the existence of “amygdalar epilepsy”. The 11-year seizure-free period following the stereotactic destruction of the amygdala is a strong argument for this notion. The late seizure recurrence requiring a second operation might, however, be seen as an argument for the important role of the hippocampal formation in the syndrome of mesial temporal lobe epilepsy even when the amygdala has been identified as the seizure onset zone. The role of stereotactic amygdalotomy is briefly reviewed.
Clinical findings, imaging characteristics and outcome in catastrophic post-encephalitic epilepsy
Eugen Trinka, François Dubeau, Frederick Andermann, Alexandre Bastos, Andrew Hui, Li Min Li, Stefan Köhler, André Olivier
HASH(0xc29ec90)
A supplementary sensorimotor area involvement for both negative and positive motor phenomena. Epileptic negative myoclonus and brief asymmetric tonic seizures.
Stefano Meletti, Paolo Tinuper, Francesca Bisulli, Margherita Santucci
and video-polygraphic findings in a patient presenting with the unusual association of ENM and brief asymmetric tonic-postural seizures of cryptogenetic origin. Focal EMG silent periods in the left deltoid muscle (mean duration 81.2 ± 16.4 ms), time-locked with vertex spikes were present. The time lag between spikes and ENM was 33.1 ± 4.6 ms. We suggest the involvement of mesial frontal areas in the genesis of both negative and positive motor phenomena.
Compte-rendu de cas
Ictal spitting during a left emporal lobe-originated complex partial seizure: a case report
Cigdem Özkara, Lütfü Hanoglu, Esat Eskazan, Isyl Baral Kulaksizogvlu, Emin Özyurt
automatism and occurs mainly with right-sided, nondominant, temporal focus. However, our patient had left mesial temporal sclerosis with nonverbal memory impairment, but intracarotid amobarbital test demonstrated language and memory dominance on the right hemisphere. The authors feel that this case supports the hypothesis of a nondominant, temporal lobe origin for the spitting automatism.
Drop episodes in Coffin-Lowry syndrome: an unusual type of startle response
R. Caraballo, A. Tesi Rocha, C. Medina, N. Fejerman
tone in both legs. Electrophysiological studies showed that these episodes are an unusual type of startle response and that they may be associated with Coffin-Lowry syndrome.
Lettre de l'éditeur
Rotatory seizures are not so rare as described Reply to the letter of Saka and Saygi, Vol. 2, No 2, June 2000
G.P. Ramelli, F. Donati, M. Kollar, L. Remonda, F. Vassella
short article was to present a videographically and electroencephalographically well documented case of rotatory seizures and not an exhaustive literature review.
Even though Saka ed al are describing 12 patients with rotatory seizure we persist in stating that rotatory seizures are a rare epileptic manifestation on the basis of literature.
On the other hand we do agree with the two authors that rotatory seizures have different aetiologies and are associated with different types of epileptic seizures which is actually mentioned in our paper.
