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Millichap JG. Prognosis of Early Onset Absence Epilepsy. Pediatr Neurol Briefs 2013. [DOI: 10.15844/pedneurbriefs-27-11-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Giordano L, Vignoli A, Cusmai R, Parisi P, Mastrangelo M, Coppola G, Cordelli DM, Accorsi P, Milito G, Darra F, Pruna D, Belcastro V, Verrotti A, Striano P. Early onset absence epilepsy with onset in the first year of life: A multicenter cohort study. Epilepsia 2013; 54 Suppl 7:66-9. [DOI: 10.1111/epi.12311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lucio Giordano
- Child Neuropsychiatry; Regional Epilepsy Center; Brescia Italy
| | - Aglaia Vignoli
- Epilepsy Center; San Paolo Hospital; University of Milan; Milan Italy
| | | | - Pasquale Parisi
- Child Neurology; NESMOS Department; Faculty of Medicine and Psychology; Sapienza University; Rome Italy
| | | | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry; Medical School; University of Salerno; Salerno Italy
| | - Duccio Maria Cordelli
- Child Neurology and Psychiatry Unit; University of Bologna; S. Orsola-Malpighi Hospital; Bologna Italy
| | | | - Giuseppe Milito
- Child Neuropsychiatry; Regional Epilepsy Center; Brescia Italy
| | | | - Dario Pruna
- Child and Adolescent Neuropsychiatry; University Hospital; Cagliari Italy
| | | | | | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa and “G. Gaslini” Institute; Genoa Italy
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Agostinelli S, Accorsi P, Beccaria F, Belcastro V, Canevini MP, Capovilla G, Cappanera S, Bernardina BD, Darra F, Gaudio LD, Elia M, Falsaperla R, Giordano L, Gobbi G, Minetti C, Nicita F, Parisi P, Pavone P, Pezzella M, Sesta M, Spalice A, Striano S, Tozzi E, Traverso M, Vari S, Vignoli A, Zamponi N, Zara F, Striano P, Verrotti A. Clinical dissection of early onset absence epilepsy in children and prognostic implications. Epilepsia 2013; 54:1761-70. [PMID: 24032425 DOI: 10.1111/epi.12341] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Sergio Agostinelli
- Child Epilepsy Center; Department of Pediatrics; University of Chieti; Chieti; Italy
| | | | | | | | | | | | - Silvia Cappanera
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | | | - Francesca Darra
- Unit of Child Neuropsychiatry; University of Verona; Verona; Italy
| | - Luigi Del Gaudio
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Maurizio Elia
- Department of Neurology; Institute “Oasi”; Troina; Italy
| | | | - Lucio Giordano
- Child Neuropsychiatry Unit; Hospital “Civile”; Brescia; Italy
| | - Giuseppe Gobbi
- Department of Child Neuropsychiatry; Hospital “Maggiore”; Bologna; Italy
| | - Carlo Minetti
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Francesco Nicita
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Pasquale Parisi
- Child Neurology; II Faculty of Medicine; La Sapienza University; Rome; Italy
| | - Piero Pavone
- Department of Pediatrics; Hospital “V. Emanuele”; Catania; Italy
| | - Marianna Pezzella
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Michela Sesta
- Child Neurology; Children's Hospital “Giovanni XIII”; Bari; Italy
| | - Alberto Spalice
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Salvatore Striano
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Elisabetta Tozzi
- Department of Child Neuropsychiatry; University of L'Aquila; L'Aquila; Italy
| | - Monica Traverso
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Stella Vari
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | | | - Nelia Zamponi
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | - Federico Zara
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
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Abstract
Absence seizures are common within many different epilepsies and span all the ages. Even though absence seizures were described more than three centuries ago advances associated with its classification, pathophysiology, genetics, treatment, prognosis, and associated co-morbidities continue to be made.
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Verrotti A, Striano P, Agostinelli S. Early onset absence epilepsy: what changes using Panayiotopoulos's criteria? Epilepsia 2013; 54:765-6. [PMID: 23550934 DOI: 10.1111/epi.12097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chipaux M, Vercueil L, Kaminska A, Mahon S, Charpier S. Persistence of cortical sensory processing during absence seizures in human and an animal model: evidence from EEG and intracellular recordings. PLoS One 2013; 8:e58180. [PMID: 23483991 PMCID: PMC3587418 DOI: 10.1371/journal.pone.0058180] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/31/2013] [Indexed: 11/19/2022] Open
Abstract
Absence seizures are caused by brief periods of abnormal synchronized oscillations in the thalamocortical loops, resulting in widespread spike-and-wave discharges (SWDs) in the electroencephalogram (EEG). SWDs are concomitant with a complete or partial impairment of consciousness, notably expressed by an interruption of ongoing behaviour together with a lack of conscious perception of external stimuli. It is largely considered that the paroxysmal synchronizations during the epileptic episode transiently render the thalamocortical system incapable of transmitting primary sensory information to the cortex. Here, we examined in young patients and in the Genetic Absence Epilepsy Rats from Strasbourg (GAERS), a well-established genetic model of absence epilepsy, how sensory inputs are processed in the related cortical areas during SWDs. In epileptic patients, visual event-related potentials (ERPs) were still present in the occipital EEG when the stimuli were delivered during seizures, with a significant increase in amplitude compared to interictal periods and a decrease in latency compared to that measured from non-epileptic subjects. Using simultaneous in vivo EEG and intracellular recordings from the primary somatosensory cortex of GAERS and non-epileptic rats, we found that ERPs and firing responses of related pyramidal neurons to whisker deflection were not significantly modified during SWDs. However, the intracellular subthreshold synaptic responses in somatosensory cortical neurons during seizures had larger amplitude compared to quiescent situations. These convergent findings from human patients and a rodent genetic model show the persistence of cortical responses to sensory stimulations during SWDs, indicating that the brain can still process external stimuli during absence seizures. They also demonstrate that the disruption of conscious perception during absences is not due to an obliteration of information transfer in the thalamocortical system. The possible mechanisms rendering the cortical operation ineffective for conscious perception are discussed, but their definite elucidation will require further investigations.
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Affiliation(s)
- Mathilde Chipaux
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC/INSERM UMR-S 975; CNRS UMR 7225, Hôpital Pitié-Salpêtrière, Paris, France
- Pediatric Neurosurgery Unit, Fondation Ophtalmologique A. de Rothschild, Paris, France
| | - Laurent Vercueil
- Grenoble Institute of Neurosciences, Centre de Recherche INSERM U 836-UJF-CEA-CHU, Equipe 9, Grenoble, France
| | - Anna Kaminska
- AP-HP, Service d'explorations fonctionnelles, laboratoire de neurophysiologie clinique, Hôpital Necker Enfants Malades, Paris, France
| | - Séverine Mahon
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC/INSERM UMR-S 975; CNRS UMR 7225, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Charpier
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC/INSERM UMR-S 975; CNRS UMR 7225, Hôpital Pitié-Salpêtrière, Paris, France
- UPMC University Paris 06, Paris, France
- * E-mail:
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57
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Berg AT, Cross JH. Classification of epilepsies and seizures: historical perspective and future directions. HANDBOOK OF CLINICAL NEUROLOGY 2012; 107:99-111. [PMID: 22938965 DOI: 10.1016/b978-0-444-52898-8.00005-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Anne T Berg
- Children's Memorial Hospital, Chicago, IL, USA.
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Pediaditis M, Tsiknakis M, Koumakis L, Karachaliou M, Voutoufianakis S, Vorgia P. Vision-based absence seizure detection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2012:65-68. [PMID: 23365833 DOI: 10.1109/embc.2012.6345872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In order to diagnose epilepsy, neurologists rely on their experience, performing an equal assessment of the electroencephalogram and the clinical image. Since misdiagnosis reaches a rate of 30% and more than one-third of all epilepsies are poorly understood, a need for leveraging diagnostic precision is obvious. With the aim at enhancing the clinical image assessment procedure, this paper evaluates the suitability of certain facial expression features for detecting and quantifying absence seizures. These features are extracted by means of time-varying signal analysis from signals that are gained by applying computer vision techniques, such as face detection, dense optical flow computation and averaging background subtraction. For the evaluation, video sequences of four patients with absence seizures are used. The classification performance of a C4.5 decision tree shows accuracies of up to 99.96% with a worst percentage of incorrectly classified instances of 0.14%.
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Affiliation(s)
- M Pediaditis
- FORTH, Computational Medicine Laboratory (CML), Institute of Computer Science (ICS), Vassilika Vouton, 71110 Heraklion, Crete, Greece.
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Panayiotopoulos CP. The new ILAE report on terminology and concepts for organization of epileptic seizures: A clinician’s critical view and contribution. Epilepsia 2011; 52:2155-60. [DOI: 10.1111/j.1528-1167.2011.03288.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Electroclinical features of absence seizures in sleep. Epilepsy Res 2011; 93:216-20. [DOI: 10.1016/j.eplepsyres.2010.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 12/16/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Caraballo RH, Darra F, Fontana E, Garcia R, Monese E, Dalla Bernardina B. Absence seizures in the first 3 years of life: an electroclinical study of 46 cases. Epilepsia 2011; 52:393-400. [PMID: 21269284 DOI: 10.1111/j.1528-1167.2010.02926.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Early onset absence seizures have been considered a rare heterogeneous group with a poor prognosis. Only few patients may be categorized into well-known syndromes. We have evaluated electroclinical features, evolution, and the nosologic boundaries of early onset absence seizures. METHODS Forty-six neurologically normal patients with absence seizures associated with bilateral, synchronic, or asynchronic, and symmetric or asymmetric spike-and-wave paroxysms with onset in the first 3 years of life were included. Patients with abnormal neurologic examination and brain imaging were excluded from the study. KEY FINDINGS In our study, 39 patients met the clinical and electroencephalography (EEG) criteria of well-defined epileptic syndromes. Childhood absence epilepsy was found in 11 patients, benign myoclonic epilepsy in infancy in 18 patients, eyelid myoclonic epilepsy in 4, and epilepsy with myoclonic absences in 6. We did not find clinical and EEG criteria of well-recognized epileptic syndromes in seven children. Nine of 11 patients with simple absence seizures became seizure free. All these patients had normal neurologic and neuropsychological evaluations. Of the 35 patients who had absence seizures associated with myoclonic seizures, 20 became seizure free. Fifteen of 35 children continue having seizures. At the last visit, 20 of these 35 patients had normal neurologic and neuropsychological evaluations, 11 presented with mild mental retardation, and 4 with severe mental retardation. SIGNIFICANCE Epilepsies with absence seizures of early onset are relatively uncommon. Most of the patients had well-defined epileptic syndromes with a variable evolution. The evolution depended on the epileptic syndromes.
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Affiliation(s)
- Roberto Horacio Caraballo
- Department of Neurology, Hospital Nacional de Pediatría Prof Dr Juan P Garrahan, Buenos Aires, Argentina.
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Moeller F, LeVan P, Muhle H, Stephani U, Dubeau F, Siniatchkin M, Gotman J. Absence seizures: individual patterns revealed by EEG-fMRI. Epilepsia 2010; 51:2000-10. [PMID: 20726875 DOI: 10.1111/j.1528-1167.2010.02698.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Absences are characterized by an abrupt onset and end of generalized 3-4 Hz spike and wave discharges (GSWs), accompanied by unresponsiveness. Although previous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) studies showed that thalamus, default mode areas, and caudate nuclei are involved in absence seizures, the contribution of these regions throughout the ictal evolution of absences remains unclear. Furthermore, animal models provide evidence that absences are initiated by a cortical focus with a secondary involvement of the thalamus. The aim of this study was to investigate dynamic changes during absences. METHODS Seventeen absences from nine patients with absence epilepsy and classical pattern of 3-4 Hz GSWs during EEG-fMRI recording were included in the study. The absences were studied in a sliding window analysis, providing a temporal sequence of blood oxygen-level dependent (BOLD) response maps. RESULTS Thalamic activation was found in 16 absences (94%), deactivation in default mode areas in 15 (88%), deactivation of the caudate nuclei in 10 (59%), and cortical activation in patient-specific areas in 10 (59%) of the absences. Cortical activations and deactivations in default mode areas and caudate nucleus occurred significantly earlier than thalamic responses. DISCUSSION Like a fingerprint, patient-specific BOLD signal changes were remarkably consistent in space and time across different absences of one patient but were quite different from patient to patient, despite having similar EEG pattern and clinical semiology. Early frontal activations could support the cortical focus theory, but with an addition: This early activation is patient specific.
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Affiliation(s)
- Friederike Moeller
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
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Dysfunction of executive and related processes in childhood absence epilepsy. Epilepsy Behav 2010; 18:414-23. [PMID: 20656561 DOI: 10.1016/j.yebeh.2010.05.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 05/08/2010] [Accepted: 05/13/2010] [Indexed: 11/22/2022]
Abstract
The nature and extent of the neuropsychological difficulties associated with childhood absence epilepsy (CAE) remain unclear. Because aberrant thalamocortical rhythms have been implicated in the pathogenesis of CAE, it was hypothesized that children with CAE would show greater difficulties in neuropsychological domains that are thought to be subserved by basal ganglia-thalamocortical circuits. Multivariate analysis of variance was used to compare the neuropsychological functioning of 16 children with CAE with that of 14 children with type 1 diabetes mellitus and 15 healthy children. The CAE group did not perform differently from the other groups on measures of intellectual functioning, memory, academic achievement, fine motor speed, or processing speed. In contrast, significant differences were found in problem solving, letter fluency, complex motor control, attention/behavioral inhibition, and psychosocial functioning. These results suggest that children with CAE show difficulties in neuropsychological functions thought to be subserved by the same regions implicated in the pathogenesis of the disorder.
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65
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Absence epilepsy and periventricular nodular heterotopia. Seizure 2010; 19:450-2. [PMID: 20637656 DOI: 10.1016/j.seizure.2010.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Accepted: 06/17/2010] [Indexed: 11/22/2022] Open
Abstract
We report a case of a girl who presented with typical absence seizures at age of 4.5 years. EEG showed absence seizures of sudden onset with 3 Hz spike-and-waves that also correlated with the clinical absences. The seizure semiology included subtle deviation of the eyes which prompted MRI investigation of the brain. This showed a periventricular nodular heterotopia in the mid to anterior horn of the right lateral ventricle. Although possibly coincidental, periventricular heterotopia are considered to be epileptogenic and this association has been reported once before. Migration disorders, such as in the periventricular heterotopia of our patient, may influence the formation and excitability of the striato-thalamo-cortical network involved in the generation of 3 Hz spike-waves.
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66
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Akman O, Demiralp T, Ates N, Onat FY. Electroencephalographic differences between WAG/Rij and GAERS rat models of absence epilepsy. Epilepsy Res 2010; 89:185-93. [PMID: 20092980 DOI: 10.1016/j.eplepsyres.2009.12.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 12/14/2009] [Accepted: 12/17/2009] [Indexed: 02/01/2023]
Abstract
The inbred Wistar Albino Glaxo Rats from Rijswijk (WAG/Rij) and the Genetic Absence Epilepsy Rats from Strasbourg (GAERS) are well-validated genetic models of absence epilepsy. Although they share similar characteristics including the spike-and-wave discharges (SWDs) in the EEG, some differences have been reported between both strains. This study aimed a systematic and detailed comparison of the SWD patterns of both strains in terms of the intensity, frequency and waveform morphology of the discharges by using exactly the same measurement and analysis techniques. The number, cumulative total duration and mean duration of SWDs were significantly higher in GAERS compared to WAG/Rij, while the discharge frequency was higher in the WAG/Rij. Furthermore, SWDs spectra and average SWD waveforms indicated that a single cycle of the SWD contains more energy in faster components such as spike and late positive transient in the GAERS. Additionally, WAG/Rij exhibited a significantly higher power between 8 and 14 Hz during the pre-SWD period. These clear phenomenological differences in the EEGs of both animal models suggest that these variables may represent basic phenotypic features of SWDs that should be sought after in the future studies that explore the genetic and molecular basis of absence epilepsy.
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Affiliation(s)
- Ozlem Akman
- Istanbul Bilim University, Faculty of Medicine, Department of Physiology, Istanbul, Turkey.
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67
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Striano P, Striano S, Beghi E, Capovilla G. Comment on “Factors influencing clinical features of absence seizures”. Epilepsia 2009; 50:2003-4. [DOI: 10.1111/j.1528-1167.2009.02083.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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68
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Scheffer IE, Berg AT. Classification and clinical features of absence epilepsies: how evidence leads to changing concepts. Epilepsia 2009; 49:2140-1. [PMID: 19049570 DOI: 10.1111/j.1528-1167.2008.01904.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ingrid E Scheffer
- Epilepsy Research Centre , Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
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