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Cossette-Roberge H, Li J, Citherlet D, Nguyen DK. Localizing and lateralizing value of auditory phenomena in seizures. Epilepsy Behav 2023; 145:109327. [PMID: 37422934 DOI: 10.1016/j.yebeh.2023.109327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Auditory seizures (AS) are a rare type of focal seizures. AS are classically thought to involve a seizure onset zone (SOZ) in the temporal lobe, but there remain uncertainties about their localizing and lateralizing value. We conducted a narrative literature review with the aim of providing an up-to-date description of the lateralizing and localizing value of AS. METHODS The databases PubMed, Scopus, and Google Scholar were searched for literature on AS in December 2022. All cortical stimulation studies, case reports, and case series were analyzed to assess for auditory phenomena that were suggestive of AS and to evaluate if the lateralization and/or localization of the SOZ could be determined. We classified AS according to their semiology (e.g., simple hallucination versus complex hallucination) and the level of evidence with which the SOZ could be predicted. RESULTS A total of 174 cases comprising 200 AS were analyzed from 70 articles. Across all studies, the SOZ of AS were more often in the left (62%) than in the right (38%) hemisphere. AS heard bilaterally followed this trend. Unilaterally heard AS were more often due to a SOZ in the contralateral hemisphere (74%), although they could also be ipsilateral (26%). The SOZ for AS was not limited to the auditory cortex, nor to the temporal lobe. The areas more frequently involved in the temporal lobe were the superior temporal gyrus (STG) and mesiotemporal structures. Extratemporal locations included parietal, frontal, insular, and rarely occipital structures. CONCLUSION Our review highlighted the complexity of AS and their importance in the identification of the SOZ. Due to the limited data and heterogeneous presentation of AS in the literature, the patterns associated with different AS semiologies warrant further research.
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Affiliation(s)
- Hélène Cossette-Roberge
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada.
| | - Jimmy Li
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Daphné Citherlet
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Dang Khoa Nguyen
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Neurosciences, Université de Montréal, Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
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Guo Y, Lv X, Zhang J, Li C, Wei L, Zhou N, Xu J, Tian Y, Wang K. Gray matter atrophy and corresponding impairments in connectivity in patients with anti-N-methyl-D-aspartate receptor encephalitis. Brain Imaging Behav 2022; 16:2001-2010. [PMID: 35997922 DOI: 10.1007/s11682-022-00670-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 11/02/2022]
Abstract
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune disease that is commonly accompanied by cognitive impairment and various neurological and psychiatric symptoms, advanced image analyses help explore the pathogenesis of this disease. Therefore, this study aimed to explore specific structural and functional alterations and their relationship with the clinical symptoms of anti-NMDAR encephalitis. In this study, twenty-two patients with anti-NMDAR encephalitis after the acute stage and 29 controls received cognitive assessments and magnetic resonance imaging. Grey matter atrophy was measured using voxel-based morphometry, and functional alterations in abnormal regions were subsequently investigated using resting state functional connectivity (RSFC). Finally, correlation analyses were performed to explore the associations between imaging alterations and cognitive assessments. The patients demonstrated significant gray matter atrophy in the bilateral triangle part of the inferior frontal gyrus (triIFG.L and triIFG.R) and right precuneus, decreased RSFC between triIFG.L and bilateral Heschl gyrus (HES), decreased RSFC between triIFG.R and HES.R, decreased RSFC between right precuneus and left cerebellum, and increased RSFC between triIFG.R and left superior frontal gyrus. Further correlation analyses showed that the gray matter volume in triIFG.R and decreased RSFC between triIFG.L and HES.R were associated with decreased memory scores, whereas decreased RSFC between triIFG.R and HES.R was marginally correlated with the disease course in patients. In conclusion, this study suggests that cognitive impairments in patients with anti-NMDAR encephalitis may be mainly associated with gray matter atrophy and abnormal RSFC in the triIFG. These findings provide new insights into anti-NMDAR encephalitis pathogenesis and help explore potential treatments.
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Affiliation(s)
- Yuanyuan Guo
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Xinyi Lv
- Department of Neurology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Juanjuan Zhang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Chenglong Li
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Ling Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Nong Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China. .,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China.
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China.,The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China
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Lee D, Lee J, Lee J. Frontal Lobe Epilepsy in a Pediatric Population: Characterization of Clinical Manifestations and Semiology. ANNALS OF CHILD NEUROLOGY 2022. [DOI: 10.26815/acn.2022.00185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: Frontal lobe epilepsy (FLE) has various clinical presentations depending on the anatomy involved. Seizures are brief and can mimic psychiatric conditions, and patients often cannot describe the aura. Therefore, it is difficult to characterize the semiology, especially in pediatric patients. This study investigated the characteristics of pediatric FLE.Methods: We retrospectively reviewed the data of pediatric patients with FLE who underwent long-term video-electroencephalography (EEG) monitoring between January 2010 and June 2020. Patients’ demographic data, seizure-related clinical presentations, semiology, brain magnetic resonance imaging (MRI), and EEG data were analyzed.Results: Fifty-six patients were included (31 males, 25 females). The age of seizure onset varied from 1 month to 14 years (mean±standard deviation, 6.1±4.4 years). Seizures were classified into nine categories, including focal tonic (30/56), aura (22/56), hypermotor (17/56), focal clonic (15/56), versive (13/56), and bilateral asymmetric tonic (4/56). Seventeen patients (30.4%) had abnormal MRI results, including focal cortical dysplasia, heterotopic gray matter, and neuroepithelial tumors. Ictal EEG changes were commonly observed in the dorsolateral premotor and central cortices. In focal tonic seizures, EEG changes often originated in the premotor cortex. The location of the lesions on MRI and EEG coincided in six cases.Conclusion: In pediatric FLE, various seizure types occur depending on the ictal anatomic origin, and individual patients had multiple semiologies. Brain MRI was normal in two-thirds of patients, and interictal EEG did not reveal epileptiform discharges in approximately 25%. Semiology reported on the basis of home videos and interictal EEG will help localize the ictal onset zone.
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Licchetta L, Vignatelli L, Zenesini C, Mostacci B, Ferri L, Provini F, Tinuper P, Bisulli F. Sleep‐related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures. Epilepsia 2019; 60:e115-e120. [DOI: 10.1111/epi.16369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Laura Licchetta
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Luca Vignatelli
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
| | - Corrado Zenesini
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
| | - Barbara Mostacci
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Federica Provini
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Paolo Tinuper
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Francesca Bisulli
- IRCCS, Istituto delle Scienze Neurologiche di Bologna Bologna Italy
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
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Vasta R, Sarica A, Bisulli F, Di Gennaro G, D'Aniello A, Difrancesco JC, Canafoglia L, Casazza M, Franceschetti S, Stipa C, Tinuper P, Mumoli L, Gambardella A, Labate A. Advanced morphological neuroimaging study in lateral temporal lobe epilepsy: A multicentric study. Epilepsy Behav 2017; 74:69-72. [PMID: 28728046 DOI: 10.1016/j.yebeh.2017.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/01/2017] [Accepted: 06/11/2017] [Indexed: 11/30/2022]
Abstract
Lateral temporal lobe epilepsy (lTLE) is a rare condition characterized by auditory auras or receptive aphasia, negative MRI, and relatively benign evolution. With the low number of cases in the world, our objective was to analyze a cohort of sporadic cases with lTLE (slTLE), in order to investigate possible cerebral morphological alterations. Forty patients with lTLE (34.93±12.08years of age) and 38 healthy controls (CTRL, 34.55±9.08years of age) were enrolled from four tertiary Italian epilepsy centers, which provided brain MRI T1-weighted images following a standard protocol for patients with epilepsy. We performed group comparison by following different approaches: voxel-based morphometry (VBM, SPM8), cortical thickness (CT), and local gyrification index (lGI) (FreeSurfer 5.3). At a more conservative threshold (p<0.05, FWE correction), no significant differences between groups survived, neither in VBM nor CT/lGI. Multicenter studies have more power than smaller studies in conducting sophisticated evaluations of rare diseases, and further investigations are required to develop a full picture of this rare phenotype.
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Affiliation(s)
- Roberta Vasta
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Alessia Sarica
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Francesca Bisulli
- IRCCS Institute of Neurological Science of Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | | | | | - Jacopo C Difrancesco
- Neurology Unit, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy; Neurophysiology and Diagnostic Epilepsy, Besta's Institute, Milano, Italy
| | - Laura Canafoglia
- Neurophysiology and Diagnostic Epilepsy, Besta's Institute, Milano, Italy
| | - Marina Casazza
- Neurophysiology and Diagnostic Epilepsy, Besta's Institute, Milano, Italy
| | | | - Carlotta Stipa
- IRCCS Institute of Neurological Science of Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Paolo Tinuper
- IRCCS Institute of Neurological Science of Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Laura Mumoli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Antonio Gambardella
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy; Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Angelo Labate
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy; Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
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Miano S, Esposito M, Foderaro G, Ramelli GP, Pezzoli V, Manconi M. Sleep-Related Disorders in Children with Attention-Deficit Hyperactivity Disorder: Preliminary Results of a Full Sleep Assessment Study. CNS Neurosci Ther 2016; 22:906-914. [PMID: 27255788 DOI: 10.1111/cns.12573] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/10/2016] [Accepted: 05/05/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND AND METHODS We present the preliminary results of a prospective case-control sleep study in children with a diagnosis of attention-deficit hyperactivity disorder (ADHD). A deep sleep assessment including sleep questionnaires, sleep habits, a video-polysomnographic recording with full high-density electroencephalography (EEG) and cardiorespiratory polygraphy, multiple sleep latency test, and 1-week actigraphic recording were performed to verify whether children with ADHD may be classified into one of the following five phenotypes: (1) hypoarousal state, resembling narcolepsy, which may be considered a "primary" form of ADHD; (2) delayed sleep onset insomnia; (3) sleep-disordered breathing; (4) restless legs syndrome and/or periodic limb movements; and (5) sleep epilepsy and/or EEG interictal epileptiform discharges. RESULTS Fifteen consecutive outpatients with ADHD were recruited (two female, mean age 10.6 ± 2.2, age range 8-13.7 years) over 6 months. The narcolepsy-like sleep phenotype was observed in three children, the sleep onset insomnia phenotype was observed in one child, mild obstructive sleep apnea was observed in three children, sleep hyperkinesia and/or PLMs were observed in five children, while IEDs and or nocturnal epilepsy were observed in three children. Depending on the sleep phenotype, children received melatonin, iron supplementation, antiepileptic drugs, or stimulants. CONCLUSIONS Our study further highlights the need to design an efficient sleep diagnostic algorithm for children with ADHD, thereby more accurately identifying cases in which a full sleep assessment is indicated.
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Affiliation(s)
- Silvia Miano
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland.
| | - Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Giuseppe Foderaro
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Gian Paolo Ramelli
- Department of Pediatrics, San Giovanni Hospital, Bellinzona, Switzerland
| | - Valdo Pezzoli
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Mauro Manconi
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland
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Gibbs SA, Proserpio P, Terzaghi M, Pigorini A, Sarasso S, Lo Russo G, Tassi L, Nobili L. Sleep-related epileptic behaviors and non-REM-related parasomnias: Insights from stereo-EEG. Sleep Med Rev 2016; 25:4-20. [DOI: 10.1016/j.smrv.2015.05.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/13/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
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