- Email: [email protected]
PO10.3 Abnormal Temperature Perception in Patients with Idiopathic Restless Legs Syndrome
S74
Posters: PO10. Epilepsy
PO10. Epilepsy
PO10.3 Abnormal Temperature Perception in Patients with Idiopathic Restless Legs Syndrome
PO10.1 The Effects of Topiramate and Sodium Valproate Retard Tablet on Cognitive Function in Adult with Epilepsy
Young-Min Lim *, Kwang Kuk Kim Dept. of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Korea E-mail address: [email protected]
Hong Xu *, Ming-Zhi Zhang, Fa-qing Long Dept. of Neurology, The First Affiliated Hospital of Kunming Medical College, China E-mail address: [email protected] Background: To evaluate the effects of topiramate (TPM) and sodium valproate retard tablet (VAP) on cognitive function in adult patients with epilepsy. Methods: Sixty two adult patients, newly diagnosed as epilepsy, were randomly divided into 2 groups: 1) TPM Group (n = 30): patients were only treated with monotherapy of TPM; 2) VAP Group (n = 32): patients were only treated with VAP. The cognitive function of all the patients in these two groups were evaluated by the Revised Adult Wechsler memory scale (WMS-RC) and event related potentials (ERPs) before treatment and two months after administration of TPM/VAP. Results: 1. After administration of TPM/VAP, there were significant differences between these two groups with respect to 13 parameters, which were sequence counts of 1 to 100 (P < 0.01), sequence counts of 100 to 1 (P < 0.01), digit cumulate cognitive function (P < 0.01), cards recognition (P < 0.01), cards remembrance (P < 0.01), cards reclamation (P < 0.01), word association (P < 0.01), object touch (P < 0.01), story apprehension (P < 0.01), natural order and anti-natural order repeat of digit (P < 0.01), and MQ (P < 0.01). In the ERPs, the P3 wave latency (P < 0.01) and amplitude of P3 wave (P < 0.01) were significant. 2. The transient memory of WMS-RC was reversely correlated with the P3 wave latency (P < 0.05). Conclusions: After administration of TPM, patients with epilepsy who are in the drug titration phase are more likely to suffer from many cognitive disturbances. PO10.2 Video-EEG Monitoring Differences in Pediatric Frontal and Temporal Lobe Epilepsy Yue Hu *, Li Jiang, Qin Zhang Dept. of Neurology, Children’s Hospital affiliated to Chongqing University of Medical Sciences, China E-mail address: [email protected] Background: To explore the clinical manifestations and EEG features in pediatric frontal and temporal lobe epilepsy based on video-EEG monitoring. Methods: Video-EEG monitoring was conducted for 6 24 hours in children with seizure disorder. Results: (1) There were less children with temporal lobe epilepsy (TLE) than children with frontal lobe epilepsy (FLE), but with no statistical significance (P = 0.132). Of the TLE, the lateral TLE was most common, and the medial TLE was rare (p = 0.001). (2) The average duration of mesial TLE was longer than that of FLE and lateral TLE (p < 0.05). There were no significant differences in seizure frequency and nocturnal attacks between children with TLE and children with FLE. (3) The psychiatric symptoms of TLE were prominent and complex, most without audible. Oropharyngeal or hand automatism were the main types of automatisms in TLE (p < 0.01). Bizarre hyperactive automatisms were prominent in FLE (p < 0.01). (4) We observed the interictal EEG from three aspects, including the background, the location of discharges and the time of discharges. The frequency of the multi-focal and bilateral discharges of FLE was higher than that of TLE (p < 0.01). The discharges of FLE easily and quickly spread to bilateral hemispheres and form secondary bilateral synchrony. Focal discharges predominated in TLE, and rarely showed the paroxysm of bilateral synchronous rhythm. Bursts of spikes/ sharp rhythms predominated in TLE during the ictal period, accounting for over 70 percent of all cases. In contrast, there were a variety of ictal EEG in FLE (p < 0.01). Conclusions: The clinical and EEG characteristics of TLE were different from those of FLE in children.
Background: Abnormal thermal thresholds have been reported in patients with restless legs syndrome (RLS), suggesting that small fiber damage or central somatosensory dysfunction may contribute to the pathogenesis of RLS. Autonomic sudomotor fibers are frequently affected and sudomotor testing is a useful diagnostic tool in distal small fiber neuropathy (DSFN), whereas sweating function in RLS has not been investigated. The aim of the present study was to evaluate temperature perception and sudomotor function in idiopathic RLS. Methods: 30 RLS patients (12 men and 18 women, median age = 53 years) and 30 age- and sex-matched healthy controls (12 men and 18 women, median age = 52.5 years) were included. All patients underwent nerve conduction studies (NCS) and lab tests. Thermal threshold for cold and warmth was assessed using quantitative sensory testing (QST) at the hand and foot. Quantitative sudomotor axon reflex test (QSART) was performed in the forearm, proximal leg, distal leg and foot to evaluate postganglionic sympathetic sudomotor function. Results: All patients showed normal NCS findings. The thermal thresholds for cold and warm sensation were significantly increased in patients as compared with age- and sex-matched controls. There was no significant difference in total sweat volume between patients and controls. RLS patients had tendency to have length dependant decrease in sweat production, but it did not reach the statistical significance. Conclusions: Temperature perception was significantly impaired in RLS, but sudomotor function was normal unlike DSFN. Our study suggests that abnormal thermal thresholds in idiopathic RLS may be associated with central somatosensory dysfunction rather than small fiber neuropathy. PO10.4 Symptomatic Occipital Lobe Epilepsy with Atypical Kinetopsia Tae Hyoung Kim1 *, Tae Il Yang1 , Jae-Wook Cho2 , Na Yoen Jung1 , Kwang Dong Choi1 1 Dept. of Neurology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Korea, 2 Dept. of Neurology, School of Medicine, Pusan National University, Yangsan Hospital, Korea E-mail address: [email protected] Background: Occipital lobe epilepsy (OLE) is an uncommon type of partial epilepsies. Usual ictal symptoms are subjective and difficult to evaluate. Most of the symptoms are visual symptoms including visual hallucinations, amaurosis, scotomas, and hemianopsia. Ictal illusory motion perception (kinetopsia) is a rare symptom of OLE. We report a case of right OLE presenting hallucinatory motion perception of object in his left visual field moving from left to right side. Case report: A 58-year-old man visited our hospital for visual hallucination that persisted 2 weeks. He is a bus driver, and the first symptom occurred while driving. He saw the cars in the lane coming toward him, moving from the left to the right side. After that, he experienced similar events frequently. The symptom started with distortion of the object in his left visual field, and then, the object moved from the left to the right side of the patient across the visual field. There was no associated blurred vision, scotomas, or amaurosis. Goldmann perimetry was normal. We performed EEG monitoring, and recorded twelve seizure events. His ictal EEG showed repetitive sharp waves on the right occipital area. Ictal SPECT revealed hyperperfusion in right parieto-temporo-occipital junction area. Brain MRI demonstrated focal meningeal enhancement at right occipital area, which was suggestive of focal meningitis or meningeal metastasis. CSF study found no significant abnormal finding. The seizure disappeared with phenytoin and oxcarbazepine. Conclusions: The patient showed ictal visual motion hallucination in the hemifield contralateral to his seizure focus. His visual hallucination seizure may be probably caused by activation of V5 area, which is known to be related to visual motion perception. Our case suggests that OLE with epileptic dysfunction of V5 area may produce hallucination moving to the epileptogenic side.
Posters: PO10. Epilepsy
PO10. Epilepsy
PO10.3 Abnormal Temperature Perception in Patients with Idiopathic Restless Legs Syndrome
PO10.1 The Effects of Topiramate and Sodium Valproate Retard Tablet on Cognitive Function in Adult with Epilepsy
Young-Min Lim *, Kwang Kuk Kim Dept. of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Korea E-mail address: [email protected]
Hong Xu *, Ming-Zhi Zhang, Fa-qing Long Dept. of Neurology, The First Affiliated Hospital of Kunming Medical College, China E-mail address: [email protected] Background: To evaluate the effects of topiramate (TPM) and sodium valproate retard tablet (VAP) on cognitive function in adult patients with epilepsy. Methods: Sixty two adult patients, newly diagnosed as epilepsy, were randomly divided into 2 groups: 1) TPM Group (n = 30): patients were only treated with monotherapy of TPM; 2) VAP Group (n = 32): patients were only treated with VAP. The cognitive function of all the patients in these two groups were evaluated by the Revised Adult Wechsler memory scale (WMS-RC) and event related potentials (ERPs) before treatment and two months after administration of TPM/VAP. Results: 1. After administration of TPM/VAP, there were significant differences between these two groups with respect to 13 parameters, which were sequence counts of 1 to 100 (P < 0.01), sequence counts of 100 to 1 (P < 0.01), digit cumulate cognitive function (P < 0.01), cards recognition (P < 0.01), cards remembrance (P < 0.01), cards reclamation (P < 0.01), word association (P < 0.01), object touch (P < 0.01), story apprehension (P < 0.01), natural order and anti-natural order repeat of digit (P < 0.01), and MQ (P < 0.01). In the ERPs, the P3 wave latency (P < 0.01) and amplitude of P3 wave (P < 0.01) were significant. 2. The transient memory of WMS-RC was reversely correlated with the P3 wave latency (P < 0.05). Conclusions: After administration of TPM, patients with epilepsy who are in the drug titration phase are more likely to suffer from many cognitive disturbances. PO10.2 Video-EEG Monitoring Differences in Pediatric Frontal and Temporal Lobe Epilepsy Yue Hu *, Li Jiang, Qin Zhang Dept. of Neurology, Children’s Hospital affiliated to Chongqing University of Medical Sciences, China E-mail address: [email protected] Background: To explore the clinical manifestations and EEG features in pediatric frontal and temporal lobe epilepsy based on video-EEG monitoring. Methods: Video-EEG monitoring was conducted for 6 24 hours in children with seizure disorder. Results: (1) There were less children with temporal lobe epilepsy (TLE) than children with frontal lobe epilepsy (FLE), but with no statistical significance (P = 0.132). Of the TLE, the lateral TLE was most common, and the medial TLE was rare (p = 0.001). (2) The average duration of mesial TLE was longer than that of FLE and lateral TLE (p < 0.05). There were no significant differences in seizure frequency and nocturnal attacks between children with TLE and children with FLE. (3) The psychiatric symptoms of TLE were prominent and complex, most without audible. Oropharyngeal or hand automatism were the main types of automatisms in TLE (p < 0.01). Bizarre hyperactive automatisms were prominent in FLE (p < 0.01). (4) We observed the interictal EEG from three aspects, including the background, the location of discharges and the time of discharges. The frequency of the multi-focal and bilateral discharges of FLE was higher than that of TLE (p < 0.01). The discharges of FLE easily and quickly spread to bilateral hemispheres and form secondary bilateral synchrony. Focal discharges predominated in TLE, and rarely showed the paroxysm of bilateral synchronous rhythm. Bursts of spikes/ sharp rhythms predominated in TLE during the ictal period, accounting for over 70 percent of all cases. In contrast, there were a variety of ictal EEG in FLE (p < 0.01). Conclusions: The clinical and EEG characteristics of TLE were different from those of FLE in children.
Background: Abnormal thermal thresholds have been reported in patients with restless legs syndrome (RLS), suggesting that small fiber damage or central somatosensory dysfunction may contribute to the pathogenesis of RLS. Autonomic sudomotor fibers are frequently affected and sudomotor testing is a useful diagnostic tool in distal small fiber neuropathy (DSFN), whereas sweating function in RLS has not been investigated. The aim of the present study was to evaluate temperature perception and sudomotor function in idiopathic RLS. Methods: 30 RLS patients (12 men and 18 women, median age = 53 years) and 30 age- and sex-matched healthy controls (12 men and 18 women, median age = 52.5 years) were included. All patients underwent nerve conduction studies (NCS) and lab tests. Thermal threshold for cold and warmth was assessed using quantitative sensory testing (QST) at the hand and foot. Quantitative sudomotor axon reflex test (QSART) was performed in the forearm, proximal leg, distal leg and foot to evaluate postganglionic sympathetic sudomotor function. Results: All patients showed normal NCS findings. The thermal thresholds for cold and warm sensation were significantly increased in patients as compared with age- and sex-matched controls. There was no significant difference in total sweat volume between patients and controls. RLS patients had tendency to have length dependant decrease in sweat production, but it did not reach the statistical significance. Conclusions: Temperature perception was significantly impaired in RLS, but sudomotor function was normal unlike DSFN. Our study suggests that abnormal thermal thresholds in idiopathic RLS may be associated with central somatosensory dysfunction rather than small fiber neuropathy. PO10.4 Symptomatic Occipital Lobe Epilepsy with Atypical Kinetopsia Tae Hyoung Kim1 *, Tae Il Yang1 , Jae-Wook Cho2 , Na Yoen Jung1 , Kwang Dong Choi1 1 Dept. of Neurology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Korea, 2 Dept. of Neurology, School of Medicine, Pusan National University, Yangsan Hospital, Korea E-mail address: [email protected] Background: Occipital lobe epilepsy (OLE) is an uncommon type of partial epilepsies. Usual ictal symptoms are subjective and difficult to evaluate. Most of the symptoms are visual symptoms including visual hallucinations, amaurosis, scotomas, and hemianopsia. Ictal illusory motion perception (kinetopsia) is a rare symptom of OLE. We report a case of right OLE presenting hallucinatory motion perception of object in his left visual field moving from left to right side. Case report: A 58-year-old man visited our hospital for visual hallucination that persisted 2 weeks. He is a bus driver, and the first symptom occurred while driving. He saw the cars in the lane coming toward him, moving from the left to the right side. After that, he experienced similar events frequently. The symptom started with distortion of the object in his left visual field, and then, the object moved from the left to the right side of the patient across the visual field. There was no associated blurred vision, scotomas, or amaurosis. Goldmann perimetry was normal. We performed EEG monitoring, and recorded twelve seizure events. His ictal EEG showed repetitive sharp waves on the right occipital area. Ictal SPECT revealed hyperperfusion in right parieto-temporo-occipital junction area. Brain MRI demonstrated focal meningeal enhancement at right occipital area, which was suggestive of focal meningitis or meningeal metastasis. CSF study found no significant abnormal finding. The seizure disappeared with phenytoin and oxcarbazepine. Conclusions: The patient showed ictal visual motion hallucination in the hemifield contralateral to his seizure focus. His visual hallucination seizure may be probably caused by activation of V5 area, which is known to be related to visual motion perception. Our case suggests that OLE with epileptic dysfunction of V5 area may produce hallucination moving to the epileptogenic side.