Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua : a European survey and analysis of 65 cases
Articolo
Data di Pubblicazione:
2011
Citazione:
Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua : a European survey and analysis of 65 cases / R. Mameniskiene, T. Bast, C. Bentes, M.P. Canevini, P. Dimova, T. Granata, H. Høgenhaven, B.J. Jakubi, P. Marusic, G. Melikyan, R. Michelucci, K.Y. Mukhin, B. Oehl, F. Ragona, A.O. Rossetti, G. Rubboli, S. Schubert, U. Stephani, J. Strobel, A. Vignoli, J. Zarubova, P. Wolf. - In: EPILEPSIA. - ISSN 0013-9580. - 52:6(2011 Jun), pp. 1168-1176.
Abstract:
PURPOSE:
To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation.
METHODS:
In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥ 1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded.
KEY FINDINGS:
Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies.
SIGNIFICANCE:
The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Aura continua; Developments of epilepsia partialis continua; Epilepsia partialis continua etiologies; Focal status epilepticus; Nonprogressive epilepsia partialis continua; Sensory epilepsia partialis continua
Elenco autori:
R. Mameniskiene, T. Bast, C. Bentes, M.P. Canevini, P. Dimova, T. Granata, H. Høgenhaven, B.J. Jakubi, P. Marusic, G. Melikyan, R. Michelucci, K.Y. Mukhin, B. Oehl, F. Ragona, A.O. Rossetti, G. Rubboli, S. Schubert, U. Stephani, J. Strobel, A. Vignoli, J. Zarubova, P. Wolf
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