Reflex epileptic features in patients with focal epilepsy of unknown cause

被引:8
作者
Atalar, Arife Cimen [1 ,2 ,3 ]
Vanli-Yavuz, Ebru Nur [1 ,2 ,4 ]
Yilmaz, Ebru [5 ]
Bebek, Nerses [1 ,2 ]
Baykan, Betul [1 ,2 ]
机构
[1] Istanbul Univ, Istanbul Fac Med, Dept Neurol, Istanbul, Turkey
[2] Istanbul Univ, Istanbul Fac Med, Clin Neurophysiol Unit, Istanbul, Turkey
[3] Istanbul Educ & Res Hosp, Istanbul, Turkey
[4] Koc Univ Hosp, Dept Neurol, Istanbul, Turkey
[5] Istanbul Univ, Istanbul Fac Med, Dept Nucl Med, Istanbul, Turkey
关键词
Reflex seizure; Focal epilepsy of unknown cause; Reflex trigger; Photosensitivity; Hot-water induced seizures; TEMPORAL-LOBE EPILEPSY; JUVENILE MYOCLONIC EPILEPSY; STARTLE EPILEPSY; ILAE COMMISSION; EEG ANALYSES; SEIZURES; PHOTOSENSITIVITY; CLASSIFICATION; DEPRESSION; TERMINOLOGY;
D O I
10.1016/j.clineuro.2019.105633
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: There is a gap of knowledge regarding reflex seizures in patients with focal epilepsy of unknown cause (FEUC). We aimed to evaluate the prevalence, demographic and clinical characteristics of reflex seizures in patients with FEUC to provide an insight to the underlying ictogenic mechanisms and to draw attention to this important but under-investigated topic. Patients and methods: After carefully questioning for reflex triggers, 186 patients diagnosed according to ILAE criteria and followed-up for a minimum of 5 years were included. The demographic and clinical properties as well as electrophysiological and neuroimaging data of these patients were reevaluated and compared to the patients without reflex seizures. Results: The reflex seizure rate was 6.5 % in patients with FEUC. Patients with reflex features had lower monotherapy rates (p = 0.005) and higher major depression rates (p = 0.001) than patients without reflex features. The distribution of the patients according to their reflex triggers were as follows: hot-water induced (n = 3, 25 %), photosensitive (n = 2, 16.7 %), eating- induced (n = 2, 16.7 %), musicogenic (n = 2, 16.7 %), startle induced (n = 2, 16.7 %) and both musicogenic and startle type (n = 1, 8.3 %) respectively. The drug resistance rate of patients with reflex seizures was 25 % (n = 3). One patient with drug resistant reflex seizures showed benefit from epilepsy surgery and became seizure-free during last 3 years of follow-up. Conclusion: A careful and thoroughly history taking specifically questioning and focusing on seizure inducing factors in patients with FEUC is needed to confirm the presence of reflex seizures in patients with FEUC, who had higher rates of polytherapy and major depression. Elaborative evaluation of reflex features in FEUC might contribute to effective seizure control, ensure new therapeutic approaches, enlighten the obscurity and the resulting anxiety of having a diagnosis of FEUC in epilepsy patients.
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页数:8
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