- Email: [email protected]
Clinical profile, EEG, CT, MRI, carbamazepine levels in 25 patients with complex partial seizures
Session 2% Ciinicai
activity in wakefulness.
EEC 2 During photic stimulation
there were abundant photic
driving and bilateraily synchronous posteriorly dominant spikes. During the follow-up of 6 months, the patient has experienced no seizures or symptoms. The sensitivity to generalized tonic-clonic seizures caused by intermittent light is associated with the photoparoxysmal response in EEG during photic stimulation. The intermittent red light has been reported to be particularly provocative. We have not found any reference to epileptic seizure induced by the use of the “brainwave synchronizer” for relaxation purposes. Presently in Finland there is a warning !abel fixed on the device that it should not be used by epileptics or pregnant women.
I%‘-10
Different Types of Movement During Temporal Lobe Seizures: Correlation of Electroclinical Features with ~e~~~~~agi~~ Abnormalities
CA. Scott, D.R. Fish. EEG Dept., National Hospital for Neurology and Neurosurgea Queen Square, London WCIN 3BG, UK Various motor phenomena are well known to occur in temporal lobe seizures. However, correlation with the pathological basis for the seizure disorder has previousiy been restricted to retrospective surgical/post mortem studies. Using video EEG telemetry, on patients who have had high resolution MRI we have to date been able to study 50 patients (209 attacks) with temporal lobe epilepsy and in viva defined hippocampal sclerosis (HS) (34 cases) or foreign tissue lesion (FTL) i 16cases). lctal onsets with scalp/sphenoidal recordings were lateralised in 63% of patients in both the FTL and HS groups. Secondary generalized seizures were seen in 19%(3) of patients with FTL and 15% (5) of patients with HS. lctal movements were divided into three categories, clonic, dystonic and automatisms. Clonic and dystonic movements were seen with equal frequency in the two groups, Automatisms were clearly different. Oral automatisms were seen in only 1116 FTL cases compared with 12/34 HS cases. Pedal automatisms were similarly less common in the FTL group than in the HS group (Oil 6 vs 5134). Conversely manuai and complex automatisms had similar representation in the two groups. These differences in automatisms presumably reflect different pathways of seizure spread.
u 37
11
Clinical Profile, EEG, CT, MRI, Carbamazepine atients with Complex partial Seizures
K.R. Shanbhogue. T.N. Krishnamoorthy, Medical CoNege, Madras, India
Susan H. Nithiyanant.
Levels
Kilpauk
Object: 25 cases of CPS were studied. Clinical substrates compared with EEG, CT, MRI (Selected cases). Serum Carbamazepine levels were done in relevant cases. Materialand Method: Age of onset, sex, Childhood febrile fits, family history were studied. The International Classification of Epilepsy was adopted. Group A (Simple paitial onset followed by LOC with or without automatisms) and Group B (LOC and automatisms at onset) were the guidelines. Clinical assessment, EEGs. sphenoidal (5). Plain and Contrast scan, and MRI (10) were done. Serum Carbamazepine levels done in resistant cases. Routine relevant, radiologic, hematologic and biochemical tests were done. Resuirss: Peak incidence in adolescent males noted. Childhood febrile seizures (36%) and family history of seizures (48%) future predictors. Group A (84%) Group B (16%). Structured hallucinations occurred in 23.8%. alimentary (40%) and intenctal Psychiatric illness in 60%. Intellectual abilities were preserved in 68%. Group A more severe than Group B, with poorer drug response and greater Psychiatric disturbances, Status Epilepticus was rare. A single interictai EEG localized the lesion in 48% emphasizing the need for special efectrodes. Sphenoidals localised in 10%. Ct localized “(tumoral)” lesions in 32%. MRI (10%) detected CT missed lesions. Serum carbamazepine levels were done in selected cases. Concitisions: (I ) Predominant onset in adolescent males, (2) Febrile fits predispose. (3) Group A worse than B. (4) Special electrodes paramount. (5) Serum Carbamazepine levels useful. (6) MRI, picked up CT missed lesions.
37-12
Electroencephalographic and Clerical Bt~dy of Postoperative Seizures in l~trac~~~~a~
M. Tsuji, S. Okada, R. Inoue, K. Sato. Juntendo Tokyo, Japan
tiniversitySciroo/ofMedic~ne,
Aim: To evaluate the risk factors of postoperative seizures in intracraniai meningioma patients and investigate indicators for discontinuing antiepileptic drugs (AED). Patients and Methods: 35 patients (IQ males and 25 females, mean age: 51.6 years, range 36 to 70 years) who had been diagnosed as having meningioma and were under treatment at our hospital between June 1983 and December 1992 (mean examination period: 28.3 months, range 6 to 103 months) were examined clinically, with EEG and imaging methods. Each EEG were visually evaluated, and in 23 patients analyzed by fast Fourier tranceformation (FFT). Patients were given AED preoperatively. Resul&: In 10 patients (28.6%). their EEGs were normal or showed only mild abnormalities, and the peak of the alpha band range ‘was increased at 2-months after their operations. AED therapy was discontinued at the time and EEG showed a stable pattern thereafter without clinical seizures. Four patients (I 1.4%) had clinical seizures. The risk factors of postoperative seizures were poor EEG prognosis, postoperative brain edema, and failure to administer AED, poor compliance, or inappropriate timing of discontinuation of AED.
SESSION 38 01 L-5
38: CLINICAL
EEG 2
Computerized EEG in Schizop~r~~~~ Patients Comparison Between untreated and Schizophrenics
T. Miyauchi, M. lshii, H. Hagimoto, S. Endo. K. Endo. S. Kajiwara, T. Tanaka Yokohama City Universily, Japan CEEG topographies were investigated and compared with acute never-treated schizophrenics (N = 21). stable remitted state (N = 21) in the same patients and normal controls (N = 30). The frequency spectrum was collapsed into delta, theta, alpha 1, alpha 2, beta 1 and beta 2 bands. These power values were designated as log transformation of relative power and t-statistic significance probability maps (SPM) were created. Both states of schizophrenics had more delta, theta, beta 1 and beta 2 activities, and less alpha 2 activity than controls. In comparison with controls, never-treated schizophrenics had more delta and less theta activities than remitted schizophrenics. On SPMs, the increased delta activity in never-treated schizophrenics was exhibited predominantly in the left hemisphere, alpha 2 activity was remarkably reduced in the posterior regions, and beta ! activity was tended to show in the left parieto-occipital regions. in contrast, attenuated a!pha 2 activity in remitted schizophrenics was restricted in the right hemispheric regions. These findings were interpreted as a corre!ate of impaired alertness, and the differences between never-treated and remitted schizophrenics were thought to be related to Lrnderlying disease process or the state.
38 02 A Correlative, EEG-Clinical L_L_l Neuro-Psychological Case A.N. Moezi. Iran
Neuro-Psychiatry Society
In 120 patients (87 male, 33 female) with enuresia (Free of systemic disorders, diabetes, urinary tract malformations, or infectious problems, Normal blood b urine analysis, etc.) the following data were found out: I) AGE: ranged 4-35 yrs old. 2): In 30 cases history of early birth problems as: (Cyanosis, Suffocation, hard delivery, use of forceps, Caesarean section, Kernicterus), 90 cases: Normal birth. 3) 32 cases head injury 8 scar on the head. 4) Clinically: 22 cases enuresia plus passive neurotic symptoms: (autism, hypoactivity, depression, low mood etc.), 65 enuresia plus potential active neurotic disorders: (aggressivity-agitation hyperactivity, etc.) IQ of 43 cases were (Borderline) 5) 19 cases had history of more than 4spells of convulsions b/or breath holding attacks. 6) EEG: 117 cases had uni or buiaterai structural &cortical irritative dysrhythmia, in 3 cases EEG: Normal. Conclusion: (I) 113 of total cases had borderline IQ. (2) The number of cerebral lesions almost match the total number of Enuresia (I 17/120). (3) The ratio of hyper to hypoactive enuresics is 3/l = 65122. (4) Anti-convulsive therapy proved to be effective.
activity in wakefulness.
EEC 2 During photic stimulation
there were abundant photic
driving and bilateraily synchronous posteriorly dominant spikes. During the follow-up of 6 months, the patient has experienced no seizures or symptoms. The sensitivity to generalized tonic-clonic seizures caused by intermittent light is associated with the photoparoxysmal response in EEG during photic stimulation. The intermittent red light has been reported to be particularly provocative. We have not found any reference to epileptic seizure induced by the use of the “brainwave synchronizer” for relaxation purposes. Presently in Finland there is a warning !abel fixed on the device that it should not be used by epileptics or pregnant women.
I%‘-10
Different Types of Movement During Temporal Lobe Seizures: Correlation of Electroclinical Features with ~e~~~~~agi~~ Abnormalities
CA. Scott, D.R. Fish. EEG Dept., National Hospital for Neurology and Neurosurgea Queen Square, London WCIN 3BG, UK Various motor phenomena are well known to occur in temporal lobe seizures. However, correlation with the pathological basis for the seizure disorder has previousiy been restricted to retrospective surgical/post mortem studies. Using video EEG telemetry, on patients who have had high resolution MRI we have to date been able to study 50 patients (209 attacks) with temporal lobe epilepsy and in viva defined hippocampal sclerosis (HS) (34 cases) or foreign tissue lesion (FTL) i 16cases). lctal onsets with scalp/sphenoidal recordings were lateralised in 63% of patients in both the FTL and HS groups. Secondary generalized seizures were seen in 19%(3) of patients with FTL and 15% (5) of patients with HS. lctal movements were divided into three categories, clonic, dystonic and automatisms. Clonic and dystonic movements were seen with equal frequency in the two groups, Automatisms were clearly different. Oral automatisms were seen in only 1116 FTL cases compared with 12/34 HS cases. Pedal automatisms were similarly less common in the FTL group than in the HS group (Oil 6 vs 5134). Conversely manuai and complex automatisms had similar representation in the two groups. These differences in automatisms presumably reflect different pathways of seizure spread.
u 37
11
Clinical Profile, EEG, CT, MRI, Carbamazepine atients with Complex partial Seizures
K.R. Shanbhogue. T.N. Krishnamoorthy, Medical CoNege, Madras, India
Susan H. Nithiyanant.
Levels
Kilpauk
Object: 25 cases of CPS were studied. Clinical substrates compared with EEG, CT, MRI (Selected cases). Serum Carbamazepine levels were done in relevant cases. Materialand Method: Age of onset, sex, Childhood febrile fits, family history were studied. The International Classification of Epilepsy was adopted. Group A (Simple paitial onset followed by LOC with or without automatisms) and Group B (LOC and automatisms at onset) were the guidelines. Clinical assessment, EEGs. sphenoidal (5). Plain and Contrast scan, and MRI (10) were done. Serum Carbamazepine levels done in resistant cases. Routine relevant, radiologic, hematologic and biochemical tests were done. Resuirss: Peak incidence in adolescent males noted. Childhood febrile seizures (36%) and family history of seizures (48%) future predictors. Group A (84%) Group B (16%). Structured hallucinations occurred in 23.8%. alimentary (40%) and intenctal Psychiatric illness in 60%. Intellectual abilities were preserved in 68%. Group A more severe than Group B, with poorer drug response and greater Psychiatric disturbances, Status Epilepticus was rare. A single interictai EEG localized the lesion in 48% emphasizing the need for special efectrodes. Sphenoidals localised in 10%. Ct localized “(tumoral)” lesions in 32%. MRI (10%) detected CT missed lesions. Serum carbamazepine levels were done in selected cases. Concitisions: (I ) Predominant onset in adolescent males, (2) Febrile fits predispose. (3) Group A worse than B. (4) Special electrodes paramount. (5) Serum Carbamazepine levels useful. (6) MRI, picked up CT missed lesions.
37-12
Electroencephalographic and Clerical Bt~dy of Postoperative Seizures in l~trac~~~~a~
M. Tsuji, S. Okada, R. Inoue, K. Sato. Juntendo Tokyo, Japan
tiniversitySciroo/ofMedic~ne,
Aim: To evaluate the risk factors of postoperative seizures in intracraniai meningioma patients and investigate indicators for discontinuing antiepileptic drugs (AED). Patients and Methods: 35 patients (IQ males and 25 females, mean age: 51.6 years, range 36 to 70 years) who had been diagnosed as having meningioma and were under treatment at our hospital between June 1983 and December 1992 (mean examination period: 28.3 months, range 6 to 103 months) were examined clinically, with EEG and imaging methods. Each EEG were visually evaluated, and in 23 patients analyzed by fast Fourier tranceformation (FFT). Patients were given AED preoperatively. Resul&: In 10 patients (28.6%). their EEGs were normal or showed only mild abnormalities, and the peak of the alpha band range ‘was increased at 2-months after their operations. AED therapy was discontinued at the time and EEG showed a stable pattern thereafter without clinical seizures. Four patients (I 1.4%) had clinical seizures. The risk factors of postoperative seizures were poor EEG prognosis, postoperative brain edema, and failure to administer AED, poor compliance, or inappropriate timing of discontinuation of AED.
SESSION 38 01 L-5
38: CLINICAL
EEG 2
Computerized EEG in Schizop~r~~~~ Patients Comparison Between untreated and Schizophrenics
T. Miyauchi, M. lshii, H. Hagimoto, S. Endo. K. Endo. S. Kajiwara, T. Tanaka Yokohama City Universily, Japan CEEG topographies were investigated and compared with acute never-treated schizophrenics (N = 21). stable remitted state (N = 21) in the same patients and normal controls (N = 30). The frequency spectrum was collapsed into delta, theta, alpha 1, alpha 2, beta 1 and beta 2 bands. These power values were designated as log transformation of relative power and t-statistic significance probability maps (SPM) were created. Both states of schizophrenics had more delta, theta, beta 1 and beta 2 activities, and less alpha 2 activity than controls. In comparison with controls, never-treated schizophrenics had more delta and less theta activities than remitted schizophrenics. On SPMs, the increased delta activity in never-treated schizophrenics was exhibited predominantly in the left hemisphere, alpha 2 activity was remarkably reduced in the posterior regions, and beta ! activity was tended to show in the left parieto-occipital regions. in contrast, attenuated a!pha 2 activity in remitted schizophrenics was restricted in the right hemispheric regions. These findings were interpreted as a corre!ate of impaired alertness, and the differences between never-treated and remitted schizophrenics were thought to be related to Lrnderlying disease process or the state.
38 02 A Correlative, EEG-Clinical L_L_l Neuro-Psychological Case A.N. Moezi. Iran
Neuro-Psychiatry Society
In 120 patients (87 male, 33 female) with enuresia (Free of systemic disorders, diabetes, urinary tract malformations, or infectious problems, Normal blood b urine analysis, etc.) the following data were found out: I) AGE: ranged 4-35 yrs old. 2): In 30 cases history of early birth problems as: (Cyanosis, Suffocation, hard delivery, use of forceps, Caesarean section, Kernicterus), 90 cases: Normal birth. 3) 32 cases head injury 8 scar on the head. 4) Clinically: 22 cases enuresia plus passive neurotic symptoms: (autism, hypoactivity, depression, low mood etc.), 65 enuresia plus potential active neurotic disorders: (aggressivity-agitation hyperactivity, etc.) IQ of 43 cases were (Borderline) 5) 19 cases had history of more than 4spells of convulsions b/or breath holding attacks. 6) EEG: 117 cases had uni or buiaterai structural &cortical irritative dysrhythmia, in 3 cases EEG: Normal. Conclusion: (I) 113 of total cases had borderline IQ. (2) The number of cerebral lesions almost match the total number of Enuresia (I 17/120). (3) The ratio of hyper to hypoactive enuresics is 3/l = 65122. (4) Anti-convulsive therapy proved to be effective.