A study on epileptic negative myoclonus in atypical benign partial epilepsy of childhood

被引:6
作者
Yang, Zhixian [1 ]
Liu, Xiaoyan [1 ]
Qin, Jiong [1 ]
Zhang, Yuehua [1 ]
Bao, Xinhua [1 ]
Chang, Xingzhi [1 ]
Wang, Shuang [1 ]
Wu, Ye [1 ]
Xiong, Hui [1 ]
机构
[1] Peking Univ, Hosp 1, Dept Pediat, Beijing 100034, Peoples R China
关键词
Epileptic negative myoclonus; Atypical benign partial epilepsy; Benign childhood epilepsy with centrotemporal spikes; Electroenceph-alogram; Surface electromyogram; Treatment; CARBAMAZEPINE; ETHOSUXIMIDE; AGGRAVATION; SEIZURE; ATONIA;
D O I
10.1016/j.braindev.2008.04.004
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective. To investigate the clinical and neurophysiological characteristics, particularly therapeutic considerations, of epileptic negative myoclonus (ENM) in atypical benign partial epilepsy (ABPE) of childhood. Methods. From 1998 to 2006, 14/242 patients with benign children epilepsy with centrotemporal spikes (BECTS) were diagnosed as having ABPE with ENM. In all 14 patients, we performed video-EEG monitoring along with tests with the patient's arms outstretched; 6/14 patients were also simultaneously underwent surface electromyogram (EMG). ENM manifestations, electrophysiological features, and responses to antiepileptic drugs were analyzed. Results. In all cases, ENM developed after the onset of epilepsy and during antiepileptic drug therapy, and the appearance of ENM were corresponding to EEG findings of high-amplitude spikes followed by a slow wave in the contralateral motor areas with secondary generalization. This was further confirmed by time-locked silent EMG. During ENM occurrence or recurrence, habitual seizures and interictal discharges were exaggerated. In some patients, the changes in antiepileptic drug regimens in relation to ENM appearance included add-on therapy with carbamazepine. oxcarbazepine, and phenobarbital or withdrawal of valproate. ENM was controlled in most cases by administration of various combinations of valproate, clonazepam, and corticosteroids. Conclusion. The incidence of ENM or ABPE in our center was approximately 5.79%. A combination of video-EEG monitoring with the patient's arms outstretched and EMG is essential to identify ENM. The aggravation of habitual seizures and interictal discharges indicate ENM. Some antiepileptic drugs, such as carbamazepine, oxcarbazepine, and phenobarbital, may be related to ENM occurrence during spontaneous aggravation of ABPE. Various combinations of valproate, benzodiazepines, and corticosteroids are relatively effective for treating ENM that Occurs in ABPE. (C) 2008 Elsevier B.V. All rights reserved.
引用
收藏
页码:274 / 281
页数:8
相关论文
共 29 条
[1]   ATYPICAL BENIGN PARTIAL EPILEPSY OF CHILDHOOD [J].
AICARDI, J ;
CHEVRIE, JJ .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 1982, 24 (03) :281-292
[2]   PROPOSAL FOR REVISED CLASSIFICATION OF EPILEPSIES AND EPILEPTIC SYNDROMES [J].
不详 .
EPILEPSIA, 1989, 30 (04) :389-399
[3]   Epileptic negative myoclonus: An EEG-single-photon emission CT study indicating involvement of premotor cortex [J].
Baumgartner, C ;
Podreka, I ;
Olbrich, A ;
Novak, K ;
Serles, W ;
Aull, S ;
Almer, G ;
Lurger, S ;
Pietrzyk, U ;
Prayer, D ;
Lindinger, G .
NEUROLOGY, 1996, 46 (03) :753-758
[4]  
Blume Warren T., 2001, Epilepsia, V42, P1212, DOI 10.1046/j.1528-1157.2001.22001.x
[5]   Ethosuximide is effective in the treatment of epileptic negative myoclonus in childhood partial epilepsy [J].
Capovilla, G ;
Beccaria, F ;
Veggiotti, P ;
Rubboli, G ;
Meletti, S ;
Tassinari, CA .
JOURNAL OF CHILD NEUROLOGY, 1999, 14 (06) :395-400
[6]   Intermittent falls and fecal incontinence as a manifestation of epileptic negative myoclonus in idiopathic partial epilepsy of childhood [J].
Capovilla, G ;
Rubboli, G ;
Beccaria, F ;
Meregalli, S ;
Veggiotti, P ;
Giambelli, PM ;
Meletti, S ;
Tassinari, CA .
NEUROPEDIATRICS, 2000, 31 (05) :273-275
[7]   Lamotrigine-induced seizure aggravation and negative myoclonus in idiopathic rolandic epilepsy [J].
Cerminara, C ;
Montanaro, ML ;
Curatolo, P ;
Seri, S .
NEUROLOGY, 2004, 63 (02) :373-375
[8]  
Chi WM, 2000, BRAIN INJURY, V14, P847
[9]   PARTIAL MOTOR EPILEPSY WITH NEGATIVE MYOCLONUS [J].
CIRIGNOTTA, F ;
LUGARESI, E .
EPILEPSIA, 1991, 32 (01) :54-58
[10]   Incidence of drug-induced aggravation in benign epilepsy with centrotemporal spikes [J].
Corda, D ;
Gelisse, P ;
Genton, P ;
Dravet, C ;
Baldy-Moulinier, M .
EPILEPSIA, 2001, 42 (06) :754-759