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P 125 Ring chromosome 20 Epilepsy syndrome in children Variable EEG- and electro-clinical pattern
e390
Abstracts / Clinical Neurophysiology 128 (2017) e305–e412
Method: 50 subjects with major depressive disorder were stimulated over 20 min. in the area of the auricular branch of the vagus nerve. Control stimulation (CS) was done at the ear lobe. Before and after each stimulation the participants were asked to rate their actual affective state. 30 participants were stimulated continuously, while in 20 subjects, stimulation was interrupted every 5 min. for 30 s. (pulsatile stimulation). Results: Only using pulsatile stimulation, participants significantly more often rated to feel better (F1;18 ¼ 12:35; p = 0.002) and to be more optimistic (F1;18 ¼ 12:24; p = 0.003) after aVNS than after CS. Using pulsatile as well as using continuous stimulation, subjects indicated to be more happy (F1;18 ¼ 24:61; p < 0.001 and F1;28 ¼ 8:03; p = 0.008, resp.). Rating of pictures of the Internatonal Affective Picture System (IAPS) showed no statistical significant difference between the stimulation methods. Conclusion: Stimulating in a pulsatile way showed more difference between aVNS and CS than stimulating in a continuous way. Self rating of the emotional state by means of a visual analogue scale seems to be a reliable tool for the examination of non-invasive stimulation techniques. doi:10.1016/j.clinph.2017.06.197
Conclusion: Consistent with the literature, our patients showed severe drug-resistant epilepsies with an electro-clinical complex of a fronto-temporal epilepsy with frequent, long-lasting or continuous subclinical seizure patterns and/or NCSE. Rhythmic theta as a ‘‘characteristic” EEG pattern was, however, only observed in 2/4 of our patients. Therefore, a rchr20es should be suspected in such patients also in the absence of this EEG feature. This information will help in an early identification of rchr20es, which is especially important since, without this specific diagnosis, many affected patients are considered candidates for pre-surgical diagnostics or even epilepsy surgery. doi:10.1016/j.clinph.2017.06.198
Poster P 126 Congruence of first out-patient routine EEG and in-patient EEG diagnostics in a specialized epilepsy center—B. Steinhoff *, M. Bacher, T. Intravooth, J. Stockinger, A. Staack (Epilepsiezentrum Kork, Kehl-Kork, Germany) ⇑
Poster P 125 Ring chromosome 20 Epilepsy syndrome in children Variable EEG- and electro-clinical pattern—A. Eger 1,*, T. Pieper 2, G. Kluger 3, U. Koehler 3, T. Herberhold 2, A. Zsoter 2, H. Holthausen 2, M. Staudt 2 (1 Städtisches Klinikum Dessau, Klinik für Kinder- und Jugendmedizin, Dessau, Germany, 2 Schön Klinik Vogtareuth, Epilepsiezentrum für Kinder und Jugendliche, Klinik für Neuropädiatrie und Neurologische Rehabilitation, Vogtareuth, Germany, 3 MGZ Medizinisch Genetisches Zentrum München, Zytogenetik, Microarray-Diagnostik, München, Germany) ⇑
Corresponding author.
Background: Children with ring chromosome 20 epilepsy syndrome (rchr20es) typically show severe, drug-resistant focal epilepsies characterized by frontal semiology, high susceptibility for non-convulsive status epilepticus (NCSE) and epilepsyassociated cognitive and behavioral deteriorations. EEG has been reported to show frequent or continuous subclinical seizure patterns together with characteristic rhythmic theta waves (Caneveni et al. 1998). Here, we report on clinical and EEG data in four patients. Patients and methods: Retrospective analysis of clinical and videoEEG-long-term-monitoring data of four patients (all female) with rchr20es. Age at onset of epilepsy ranged from 5 to 8 years, the number of antiepileptic drugs already used ranged from 6 to 10, and all four patients had suffered NCSE previously. Semiology: all four patients showed auras (epigastric: 2, fear: 2, visual: 1, somatosensory: 1) and seizures (hypermotor: 3, tonic: 3, dialeptic: 2, psychomotor: 2). Clinical epilepsy syndromes were frontal lobe epilepsies (n = 3) and frontal/ temporal lobe epilepsy (n = 1). EEG showed regional abnormalities in frontal (n = 4), temporal (n = 3) and parieto-occiptal (n = 1) areas, with subclinical seizure patterns and/ or EEG-status elements (with serial spikes, polyspikes, sharp waves, or spike wave complexes; n = 3), rhythmic theta (n = 2), 1–2 Hz slow sharp wave complexes (n = 1), spike wave complexes/low amplitude fast activity +high amplitude delta burst (n = 1), alpha/theta seizure activity (n = 1). MRI was essentially normal in all patients, with minor abnormalities in frontal (2) or temporal areas (2).
Corresponding author.
Background/Objective: In our epilepsy center we always perform a routine EEG in out-patients who are referred for the first time. We investigated in how many cases additional EEG diagnostics including long-term video EEG delivered additional clinically relevant information if in-patient diagnostics followed. Methods: We retrospectively assessed, how many out-patients seen for the first time were admitted to a hospital stay. In these cases we compared the EEG findings of the initial out-patient routine EEG with the in-patient data including long-term video EEG. Results: Total number of out-patients was 77. Ten patients (13%) were hospitalized with the purpose of a better diagnostic classification. In 4 of 10 epilepsy cases we found confirming epileptiform discharges in the long-term video EEG that had not been recording with the initial routine EEG. In one patient we found a normal variant where epileptiform discharges had been falsely supposed in the routine EEG. In the remaining cases no clinically relevant further information was obtained. Discussion/Conclusions: Additional hospitalizations are usually not necessary after out-patient visits of new referrals to a specialized epilepsy center. In half of these hospitalized patients additional EEG diagnostics beyond routine EEG render clinically relevant additional information. doi:10.1016/j.clinph.2017.06.199
Poster P 127 Vigilance regulation in adult ADHD—M. Strauß *, M. Paucke, C. Sander, U. Hegerl (Universitätsklinikum Leipzig AöR, Klinik für Psychiatrie und Psychotherapie, 04103, Germany) ⇑
Corresponding author.
Background: Functional regulation of vigilance or wakefulness is crucial for interaction with the environment and can be described as a unique, situation-dependent characteristic. Disorders of wakefulness regulation manifest themselves as delayed or rash declines in vigilance under calm settings.
Abstracts / Clinical Neurophysiology 128 (2017) e305–e412
Method: 50 subjects with major depressive disorder were stimulated over 20 min. in the area of the auricular branch of the vagus nerve. Control stimulation (CS) was done at the ear lobe. Before and after each stimulation the participants were asked to rate their actual affective state. 30 participants were stimulated continuously, while in 20 subjects, stimulation was interrupted every 5 min. for 30 s. (pulsatile stimulation). Results: Only using pulsatile stimulation, participants significantly more often rated to feel better (F1;18 ¼ 12:35; p = 0.002) and to be more optimistic (F1;18 ¼ 12:24; p = 0.003) after aVNS than after CS. Using pulsatile as well as using continuous stimulation, subjects indicated to be more happy (F1;18 ¼ 24:61; p < 0.001 and F1;28 ¼ 8:03; p = 0.008, resp.). Rating of pictures of the Internatonal Affective Picture System (IAPS) showed no statistical significant difference between the stimulation methods. Conclusion: Stimulating in a pulsatile way showed more difference between aVNS and CS than stimulating in a continuous way. Self rating of the emotional state by means of a visual analogue scale seems to be a reliable tool for the examination of non-invasive stimulation techniques. doi:10.1016/j.clinph.2017.06.197
Conclusion: Consistent with the literature, our patients showed severe drug-resistant epilepsies with an electro-clinical complex of a fronto-temporal epilepsy with frequent, long-lasting or continuous subclinical seizure patterns and/or NCSE. Rhythmic theta as a ‘‘characteristic” EEG pattern was, however, only observed in 2/4 of our patients. Therefore, a rchr20es should be suspected in such patients also in the absence of this EEG feature. This information will help in an early identification of rchr20es, which is especially important since, without this specific diagnosis, many affected patients are considered candidates for pre-surgical diagnostics or even epilepsy surgery. doi:10.1016/j.clinph.2017.06.198
Poster P 126 Congruence of first out-patient routine EEG and in-patient EEG diagnostics in a specialized epilepsy center—B. Steinhoff *, M. Bacher, T. Intravooth, J. Stockinger, A. Staack (Epilepsiezentrum Kork, Kehl-Kork, Germany) ⇑
Poster P 125 Ring chromosome 20 Epilepsy syndrome in children Variable EEG- and electro-clinical pattern—A. Eger 1,*, T. Pieper 2, G. Kluger 3, U. Koehler 3, T. Herberhold 2, A. Zsoter 2, H. Holthausen 2, M. Staudt 2 (1 Städtisches Klinikum Dessau, Klinik für Kinder- und Jugendmedizin, Dessau, Germany, 2 Schön Klinik Vogtareuth, Epilepsiezentrum für Kinder und Jugendliche, Klinik für Neuropädiatrie und Neurologische Rehabilitation, Vogtareuth, Germany, 3 MGZ Medizinisch Genetisches Zentrum München, Zytogenetik, Microarray-Diagnostik, München, Germany) ⇑
Corresponding author.
Background: Children with ring chromosome 20 epilepsy syndrome (rchr20es) typically show severe, drug-resistant focal epilepsies characterized by frontal semiology, high susceptibility for non-convulsive status epilepticus (NCSE) and epilepsyassociated cognitive and behavioral deteriorations. EEG has been reported to show frequent or continuous subclinical seizure patterns together with characteristic rhythmic theta waves (Caneveni et al. 1998). Here, we report on clinical and EEG data in four patients. Patients and methods: Retrospective analysis of clinical and videoEEG-long-term-monitoring data of four patients (all female) with rchr20es. Age at onset of epilepsy ranged from 5 to 8 years, the number of antiepileptic drugs already used ranged from 6 to 10, and all four patients had suffered NCSE previously. Semiology: all four patients showed auras (epigastric: 2, fear: 2, visual: 1, somatosensory: 1) and seizures (hypermotor: 3, tonic: 3, dialeptic: 2, psychomotor: 2). Clinical epilepsy syndromes were frontal lobe epilepsies (n = 3) and frontal/ temporal lobe epilepsy (n = 1). EEG showed regional abnormalities in frontal (n = 4), temporal (n = 3) and parieto-occiptal (n = 1) areas, with subclinical seizure patterns and/ or EEG-status elements (with serial spikes, polyspikes, sharp waves, or spike wave complexes; n = 3), rhythmic theta (n = 2), 1–2 Hz slow sharp wave complexes (n = 1), spike wave complexes/low amplitude fast activity +high amplitude delta burst (n = 1), alpha/theta seizure activity (n = 1). MRI was essentially normal in all patients, with minor abnormalities in frontal (2) or temporal areas (2).
Corresponding author.
Background/Objective: In our epilepsy center we always perform a routine EEG in out-patients who are referred for the first time. We investigated in how many cases additional EEG diagnostics including long-term video EEG delivered additional clinically relevant information if in-patient diagnostics followed. Methods: We retrospectively assessed, how many out-patients seen for the first time were admitted to a hospital stay. In these cases we compared the EEG findings of the initial out-patient routine EEG with the in-patient data including long-term video EEG. Results: Total number of out-patients was 77. Ten patients (13%) were hospitalized with the purpose of a better diagnostic classification. In 4 of 10 epilepsy cases we found confirming epileptiform discharges in the long-term video EEG that had not been recording with the initial routine EEG. In one patient we found a normal variant where epileptiform discharges had been falsely supposed in the routine EEG. In the remaining cases no clinically relevant further information was obtained. Discussion/Conclusions: Additional hospitalizations are usually not necessary after out-patient visits of new referrals to a specialized epilepsy center. In half of these hospitalized patients additional EEG diagnostics beyond routine EEG render clinically relevant additional information. doi:10.1016/j.clinph.2017.06.199
Poster P 127 Vigilance regulation in adult ADHD—M. Strauß *, M. Paucke, C. Sander, U. Hegerl (Universitätsklinikum Leipzig AöR, Klinik für Psychiatrie und Psychotherapie, 04103, Germany) ⇑
Corresponding author.
Background: Functional regulation of vigilance or wakefulness is crucial for interaction with the environment and can be described as a unique, situation-dependent characteristic. Disorders of wakefulness regulation manifest themselves as delayed or rash declines in vigilance under calm settings.