Seizure semiology identifies patients with bilateral temporal lobe epilepsy

被引:13
作者
Loesch, Anna Mira [1 ]
Feddersen, Berend [1 ]
Tezer, F. Irsel [1 ]
Hartl, Elisabeth [1 ]
Remi, Jan [1 ]
Vollmar, Christian [1 ]
Noachtar, Soheyl [1 ]
机构
[1] Univ Munich, Dept Neurol, Epilepsy Ctr, D-81377 Munich, Germany
关键词
Temporal lobe epilepsy; Bitemporal; Semiology; Lateralizing seizure phenomena; Epilepsy surgery; LATERALIZING SIGNIFICANCE; FOCAL EPILEPSIES; MOVEMENTS; LOBECTOMY; HEAD; EEG;
D O I
10.1016/j.eplepsyres.2014.11.002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. Methods: We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Results: Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; p < 0.001) and significantly more often lateralizing seizure phenomena pointing to bilateral seizure onset compared to patients with unilateral TLE (67% vs. 11%; p < 0.001). The sensitivity of identical vs. different seizure semiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). Significance: The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码:197 / 202
页数:6
相关论文
共 16 条
[1]   THE SURGICAL TREATMENT OF PSYCHOMOTOR EPILEPSY [J].
BAILEY, P ;
GIBBS, FA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1951, 145 (06) :365-370
[2]   AUTOMATISMS WITH PRESERVED RESPONSIVENESS - A LATERALIZING SIGN IN PSYCHOMOTOR SEIZURES [J].
EBNER, A ;
DINNER, DS ;
NOACHTAR, S ;
LUDERS, H .
NEUROLOGY, 1995, 45 (01) :61-64
[3]   The localizing value of the abdominal aura and its evolution -: A study in focal epilepsies [J].
Henkel, A ;
Noachtar, S ;
Pfänder, M ;
Lüders, HO .
NEUROLOGY, 2002, 58 (02) :271-276
[4]   Surgical outcome in PET-positive, MRI-negative patients with temporal lobe epilepsy [J].
LoPinto-Khoury, Carla ;
Sperling, Michael R. ;
Skidmore, Christopher ;
Nei, Maromi ;
Evans, James ;
Sharan, Ashwini ;
Mintzer, Scott .
EPILEPSIA, 2012, 53 (02) :342-348
[5]   Semiological seizure classification [J].
Lüders, H ;
Acharya, J ;
Baumgartner, C ;
Benbadis, S ;
Bleasel, A ;
Burgess, R ;
Dinner, DS ;
Ebner, A ;
Foldvary, N ;
Geller, E ;
Hamer, H ;
Holthausen, H ;
Kotagal, P ;
Morris, H ;
Meencke, HJ ;
Noachtar, S ;
Rosenow, F ;
Sakamoto, A ;
Steinhoff, BJ ;
Tuxhorn, I ;
Wyllie, E .
EPILEPSIA, 1998, 39 (09) :1006-1013
[6]  
NOACHTAR S, 2001, EPILEPSY COMPREHENSI, P127
[7]   Epilepsy surgery: A critical review [J].
Noachtar, Soheyl ;
Borggraefe, Ingo .
EPILEPSY & BEHAVIOR, 2009, 15 (01) :66-72
[8]   The role of EEG in epilepsy: A critical review [J].
Noachtar, Soheyl ;
Remi, Jan .
EPILEPSY & BEHAVIOR, 2009, 15 (01) :22-33
[9]   Lateralizing significance of quantitative analysis of head movements before secondary generalization of seizures of patients with temporal lobe epilepsy [J].
O'Dwyer, Rebecca ;
Cunha, Joao P. Silva ;
Vollmar, Christian ;
Mauerer, Cordula ;
Feddersen, Berend ;
Burgess, Richard C. ;
Ebner, Alois ;
Noachtar, Soheyl .
EPILEPSIA, 2007, 48 (03) :524-530
[10]   Predictors of outcome of anterior temporal lobectomy for intractable epilepsy - A multivariate study [J].
Radhakrishnan, K ;
So, EL ;
Silbert, PL ;
Jack, CR ;
Cascino, GD ;
Sharbrough, FW ;
O'Brien, PC .
NEUROLOGY, 1998, 51 (02) :465-471