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Beniczky S, Tatum WO, Blumenfeld H, Stefan H, Mani J, Maillard L, Fahoum F, Vinayan KP, Mayor LC, Vlachou M, Seeck M, Ryvlin P, Kahane P. Seizure semiology: ILAE glossary of terms and their significance. Epileptic Disord 2022; 24:447-495. [PMID: 35770761 DOI: 10.1684/epd.2022.1430] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/19/2022] [Indexed: 11/17/2022]
Abstract
This educational topical review and Task Force report aims to address learning objectives of the International League Against Epilepsy (ILAE) curriculum. We sought to extract detailed features involving semiology from video recordings and interpret semiological signs and symptoms that reflect the likely localization for focal seizures in patients with epilepsy. This glossary was developed by a working group of the ILAE Commission on Diagnostic Methods incorporating the EEG Task Force. This paper identifies commonly used terms to describe seizure semiology, provides definitions, signs and symptoms, and summarizes their clinical value in localizing and lateralizing focal seizures based on consensus in the published literature. Video-EEG examples are included to illustrate important features of semiology in patients with epilepsy.
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Turek G, Skjei K. Seizure semiology, localization, and the 2017 ILAE seizure classification. Epilepsy Behav 2022; 126:108455. [PMID: 34894624 DOI: 10.1016/j.yebeh.2021.108455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
In the study of epilepsy, the term semiology is used to comprise the clinical characteristics of a seizure, both subjective symptoms and objective phenomena. It is produced by activation of the symptomagenic zone, and an accurate and comprehensive understanding of the localizing value of seizure semiology is crucial for presurgical evaluation and planning. Myriad publications in epilepsy journals detail correlations between various semiological features and activation of specific cortical regions. Traditionally these studies involved scalp EEG recorded in epilepsy monitoring units. The increasing use of invasive monitoring, and specifically the use of depth electrodes and stereo-electroencephalography, has advanced our understanding of the characteristics of seizures arising from ictal foci deep to the scalp, including the cingulate, insula and operculum. However, the distinction between seizure onset and symptomogenic zones is not always clear. In 2017 the International League Against Epilepsy (ILAE) published an operational classification of seizure types based heavily on seizure semiology. The current paper provides an updated review of the current body of knowledge relating to seizure semiology, incorporating both scalp EEG studies and more recent stereo-electroencephalography discoveries in the framework of the 2017 ILAE classification.
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Affiliation(s)
- Grant Turek
- Department of Neurology, University of Louisville, 401 E. Chestnut St. Unit 510, Louisville, KY 40202-5710, United States.
| | - Karen Skjei
- Department of Neurology, University of Texas at Austin, Dell Medical School, 1601 Trinity St., Bldg B, Strop Z0700, Austin, TX 78712, United States
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Khasiyev F, Tezer FI, Saygi S. Lower limb automatism in surgically treated temporal lobe epilepsy patients: Clinical and electrophysiological features. J Clin Neurosci 2019; 69:51-54. [PMID: 31439484 DOI: 10.1016/j.jocn.2019.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022]
Abstract
Lower limb automatism has not been known well in temporal lobe epilepsy (TLE) patients. This study investigated the distribution of risk factors, EEG features, and pathology types in surgically treated TLE patients. We also made a comparison of this group to surgically treated TLE patients with isolated hand automatism. Twenty TLE patients with lower limb automatism (Group 1) and 20 TLE patients with isolated hand automatisms (Group 2) of similar age/sex distribution were enrolled in our study. Male/female ratio was 14/6 in both groups. Demographical characteristics, risk factors, pathology types and EEG features were compared between two groups. 15 and 8 patients out of Group 1 (75%) and Group 2 (40%) respectively, were undergone right-sided surgery. Ipsilateral lower limb automatism was seen in 80% of patients. The age of epilepsy onset was earlier in patients with lower limb automatism (p = 0.02). There was no significant difference between the groups in terms of the risk factors and other demographical characteristics. Although, EEG features were not different, onset of ictal EEG changes in the first 10 seconds were seen less frequently in Group 1(6 vs 9 patients) (p = 0.31). Hippocampal sclerosis as a pathology type was detected in 11 patients (55%) of Group 1, whereas in 16 patients (80%) of Group 2. TLE patients with lower limb automatism have an earlier age of epilepsy onset and the onset of ictal EEG changed in the first 10 seconds of clinical seizure and pure HS pathology was rarer than in TLE patients with hand automatisms. Further studies are needed to shed more light on the pathophysiology of lower extremity automatisms in TLE patients.
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Affiliation(s)
- Farid Khasiyev
- Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - F Irsel Tezer
- Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey.
| | - Serap Saygi
- Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey
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Ahmedt-Aristizabal D, Fookes C, Dionisio S, Nguyen K, Cunha JPS, Sridharan S. Automated analysis of seizure semiology and brain electrical activity in presurgery evaluation of epilepsy: A focused survey. Epilepsia 2017; 58:1817-1831. [DOI: 10.1111/epi.13907] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
- David Ahmedt-Aristizabal
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - Clinton Fookes
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - Sasha Dionisio
- Mater Centre for Neurosciences; Brisbane Queensland Australia
| | - Kien Nguyen
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - João Paulo S. Cunha
- The Institute of Systems and Computer Engineering; Technology and Science; and Faculty of Engineering; University of Porto; Porto Portugal
| | - Sridha Sridharan
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
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Ulate-Campos A, Coughlin F, Gaínza-Lein M, Fernández IS, Pearl P, Loddenkemper T. Automated seizure detection systems and their effectiveness for each type of seizure. Seizure 2016; 40:88-101. [DOI: 10.1016/j.seizure.2016.06.008] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/23/2016] [Accepted: 06/07/2016] [Indexed: 01/08/2023] Open
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Achilles F, Tombari F, Belagiannis V, Loesch AM, Noachtar S, Navab N. Convolutional neural networks for real-time epileptic seizure detection. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING-IMAGING AND VISUALIZATION 2016. [DOI: 10.1080/21681163.2016.1141062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Felix Achilles
- Computer Aided Medical Procedures, Technische Universität München, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Federico Tombari
- Computer Aided Medical Procedures, Technische Universität München, Munich, Germany
- DISI, University of Bologna, Bologna, Italy
| | - Vasileios Belagiannis
- Computer Aided Medical Procedures, Technische Universität München, Munich, Germany
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Anna Mira Loesch
- Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Soheyl Noachtar
- Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Nassir Navab
- Computer Aided Medical Procedures, Technische Universität München, Munich, Germany
- Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, USA
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Marashly A, Ewida A, Agarwal R, Younes K, Lüders HO. Ictal motor sequences: Lateralization and localization values. Epilepsia 2016; 57:369-75. [DOI: 10.1111/epi.13322] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Ahmad Marashly
- Department of Child Neurology; Children's Hospital of Wisconsin/Medical College of Wisconsin; Milwaukee Wisconsin U.S.A
| | - Amr Ewida
- Department of Neurology; Epilepsy Center; George Washington University; Washington District of Columbia U.S.A
| | - Rajkumar Agarwal
- Department of Child Neurology; Children's Hospital of Michigan/Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Kyan Younes
- Department of Neurology; University of Texas Health Sciences Center at Houston; Houston Texas U.S.A
| | - Hans O. Lüders
- Department of Neurology; Epilepsy Center; University Hospitals of Case Medical Center/Case Western Reserve University; Cleveland Ohio U.S.A
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Hagge M, Nunnemann S, Bauer S, Gollwitzer S, Oertel WH, Knake S, Rosenow F, Hamer HM. Biceps electromyography in dialeptic and automotor seizures with and without secondary generalization. Clin Neurophysiol 2016; 127:1163-1169. [DOI: 10.1016/j.clinph.2015.10.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/02/2015] [Accepted: 10/01/2015] [Indexed: 11/27/2022]
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Cunha JPS, Choupina HMP, Rocha AP, Fernandes JM, Achilles F, Loesch AM, Vollmar C, Hartl E, Noachtar S. NeuroKinect: A Novel Low-Cost 3Dvideo-EEG System for Epileptic Seizure Motion Quantification. PLoS One 2016; 11:e0145669. [PMID: 26799795 PMCID: PMC4723069 DOI: 10.1371/journal.pone.0145669] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/06/2015] [Indexed: 11/19/2022] Open
Abstract
Epilepsy is a common neurological disorder which affects 0.5-1% of the world population. Its diagnosis relies both on Electroencephalogram (EEG) findings and characteristic seizure-induced body movements--called seizure semiology. Thus, synchronous EEG and (2D)video recording systems (known as Video-EEG) are the most accurate tools for epilepsy diagnosis. Despite the establishment of several quantitative methods for EEG analysis, seizure semiology is still analyzed by visual inspection, based on epileptologists' subjective interpretation of the movements of interest (MOIs) that occur during recorded seizures. In this contribution, we present NeuroKinect, a low-cost, easy to setup and operate solution for a novel 3Dvideo-EEG system. It is based on a RGB-D sensor (Microsoft Kinect camera) and performs 24/7 monitoring of an Epilepsy Monitoring Unit (EMU) bed. It does not require the attachment of any reflectors or sensors to the patient's body and has a very low maintenance load. To evaluate its performance and usability, we mounted a state-of-the-art 6-camera motion-capture system and our low-cost solution over the same EMU bed. A comparative study of seizure-simulated MOIs showed an average correlation of the resulting 3D motion trajectories of 84.2%. Then, we used our system on the routine of an EMU and collected 9 different seizures where we could perform 3D kinematic analysis of 42 MOIs arising from the temporal (TLE) (n = 19) and extratemporal (ETE) brain regions (n = 23). The obtained results showed that movement displacement and movement extent discriminated both seizure MOI groups with statistically significant levels (mean = 0.15 m vs. 0.44 m, p<0.001; mean = 0.068 m(3) vs. 0.14 m(3), p<0.05, respectively). Furthermore, TLE MOIs were significantly shorter than ETE (mean = 23 seconds vs 35 seconds, p<0.01) and presented higher jerking levels (mean = 345 ms(-3) vs 172 ms(-3), p<0.05). Our newly implemented 3D approach is faster by 87.5% in extracting body motion trajectories when compared to a 2D frame by frame tracking procedure. We conclude that this new approach provides a more comfortable (both for patients and clinical professionals), simpler, faster and lower-cost procedure than previous approaches, therefore providing a reliable tool to quantitatively analyze MOI patterns of epileptic seizures in the routine of EMUs around the world. We hope this study encourages other EMUs to adopt similar approaches so that more quantitative information is used to improve epilepsy diagnosis.
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Affiliation(s)
- João Paulo Silva Cunha
- Institute for Systems Engineering and Computers – Technology and Science (INESC TEC), and Faculty of Engineering (FEUP), University of Porto, Porto, Portugal
| | - Hugo Miguel Pereira Choupina
- Institute for Systems Engineering and Computers – Technology and Science (INESC TEC), and Faculty of Engineering (FEUP), University of Porto, Porto, Portugal
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
| | - Ana Patrícia Rocha
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), and Department of Electronics, Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - José Maria Fernandes
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), and Department of Electronics, Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - Felix Achilles
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
- Chair for Computer Aided Medical Procedures, Technische Universitat Munchen, Munich, Germany
| | - Anna Mira Loesch
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
| | - Christian Vollmar
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
| | - Elisabeth Hartl
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
| | - Soheyl Noachtar
- Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
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Vilas-Boas MDC, Cunha JPS. Movement Quantification in Neurological Diseases: Methods and Applications. IEEE Rev Biomed Eng 2016; 9:15-31. [PMID: 27008673 DOI: 10.1109/rbme.2016.2543683] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Baysal-Kirac L, Rémi J, Loesch AM, Hartl E, Vollmar C, Noachtar S. Eye movements differ between ictal ipsilateral and contralateral head turning. Epilepsy Res 2015; 114:73-7. [PMID: 26088888 DOI: 10.1016/j.eplepsyres.2015.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/07/2015] [Accepted: 03/28/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE This study evaluated the relation of head and eye movements during ictal ipsilateral and contralateral head turning in patients with focal epilepsies with regard to lateralization of the epileptogenic zone. METHODS We reviewed our database and identified patients with ictal head turning ipsilateral and contralateral to the seizure onset as defined by ictal EEG. Twenty-seven seizures of 19 consecutive patients with ipsilateral and 40 seizures of 32 patients with contralateral head turning were investigated. Twenty-four patients had temporal lobe epilepsy (TLE), and 27 patients had extratemporal or multifocal epilepsy. KEY FINDINGS Eye movement in the same direction preceded contralateral head turning in 90% (36 of 40 seizures) of the seizures, but this was the case in only 33% (9 of 27 seizures) of the ipsilateral ictal head turning. In contrary, head turning preceded the eye movements in 67% (18 of 27 seizures) of the ipsilateral ictal head turning and in only 10% of the contralateral head turning (p < 0.001). The results were similar in TLE and FLE. SIGNIFICANCE The sequence of head and eye movements is different in ictal ipsilateral and contralateral head turning movements which likely reflects different spread patterns of epileptic activity associated with activation of different generators. The analysis of eye movements adds to the lateralization of ictal head movements.
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Affiliation(s)
- Leyla Baysal-Kirac
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Jan Rémi
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Anna Mira Loesch
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Elisabeth Hartl
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Christian Vollmar
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Soheyl Noachtar
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
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Ataoğlu EE, Yıldırım İ, Bilir E. An evaluation of lateralizing signs in patients with temporal lobe epilepsy. Epilepsy Behav 2015; 47:115-9. [PMID: 25989878 DOI: 10.1016/j.yebeh.2015.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/23/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
Resective epilepsy surgery has been accepted as an effective treatment for patients with medically intractable temporal lobe epilepsy (TLE) to control the seizures and to limit cognitive dysfunction. Complete resection of the epileptic zone, and therefore the success of the surgery, depends on the identification of the seizure focus. Reliable lateralizing semiologic signs, together with other presurgical assessments, are of great importance for an accurate identification of the seizure focus. In this respect, this study evaluated the frequency of semiologic signs in medically intractable temporal lobe epilepsy (TLE) together with the lateralizing values and variations according to the age and gender groups. Two hundred seventy-three seizures of 55 patients of the Adult Epilepsy Monitoring Unit of Gazi University Faculty of Medicine with the diagnosis of medically intractable TLE, whose epileptic foci were detected through noninvasive presurgical procedures and seizures were controlled successfully after anterior temporal lobectomy (ATL), were analyzed retrospectively. Seizure semiologies of the patients were evaluated in terms of lateralizing values, and it was inquired whether age/gender causes any variation. Versive head rotation, unilateral dystonic limb posturing, asymmetric tonic limb posturing, and the combination of unilateral hand automatisms and dystonic posturing were determined as the semiologic signs with the highest lateralizing values (90-100%). While hand automatisms were observed frequently in the group with early seizure-onset age (onset age ≤ 2), asymmetric tonic limb posturing was detected as more frequent in the group with later seizure-onset age (onset age > 2; p < .005). In addition to this, semiologic signs were noted to be different between male and female groups; psychic and autonomic auras and ictal emotional signs were associated with women (p < .005).
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Affiliation(s)
- Esra Erkoç Ataoğlu
- Department of Neurology, Ministry of Health, Zekai Tahir Burak Women's Health Research and Education Hospital, 06830 Ankara, Turkey.
| | - İrem Yıldırım
- Department of Neurology, Gazi University Faculty of Medicine, 06830 Ankara, Turkey
| | - Erhan Bilir
- Department of Neurology, Gazi University Faculty of Medicine, 06830 Ankara, Turkey
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Loesch AM, Feddersen B, Tezer FI, Hartl E, Rémi J, Vollmar C, Noachtar S. Seizure semiology identifies patients with bilateral temporal lobe epilepsy. Epilepsy Res 2015; 109:197-202. [DOI: 10.1016/j.eplepsyres.2014.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/14/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
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Silva Cunha JP, Rémi J, Vollmar C, Fernandes JM, Gonzalez-Victores JA, Noachtar S. Upper limb automatisms differ quantitatively in temporal and frontal lobe epilepsies. Epilepsy Behav 2013; 27:404-8. [PMID: 23545438 DOI: 10.1016/j.yebeh.2013.02.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 02/21/2013] [Accepted: 02/24/2013] [Indexed: 11/15/2022]
Abstract
We quantitatively evaluated the localizing and lateralizing characteristics of ictal upper limb automatisms (ULAs) in patients with temporal lobe epilepsy (TLE; n=38) and frontal lobe epilepsy (FLE; n=20). Movement speed, extent, length, and duration of ULAs were quantitatively analyzed with motion capturing techniques. Upper limb automatisms had a larger extent (p<0.001), covered more distance (p<0.05), and were faster (p<0.001) in FLE than in TLE. In TLE, the maximum speed of ULAs was higher ipsilaterally than contralaterally (173 vs. 84pixels/s; p=0.02), with no significant difference in FLE (511 vs. 428). The duration of ictal automatisms in relation to the total seizure duration was shorter in TLE than in FLE (median 36% vs. 63%; p<0.001), with no difference in the absolute duration (26s vs. 27s). These results demonstrate that quantitative movement analysis of ULAs differentiates FLE from TLE, which may aid in the localization of the epileptogenic zone.
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Affiliation(s)
- João P Silva Cunha
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Porto/INESC TEC, Porto, Portugal
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Pediaditis M, Tsiknakis M, Leitgeb N. Vision-based motion detection, analysis and recognition of epileptic seizures--a systematic review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2012; 108:1133-1148. [PMID: 22954620 DOI: 10.1016/j.cmpb.2012.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 06/26/2012] [Accepted: 08/13/2012] [Indexed: 06/01/2023]
Abstract
The analysis of human motion from video has been the object of interest for many application areas, these including surveillance, control, biomedical analysis, video annotation etc. This paper addresses the advances within this topic in relation to epilepsy, a domain where human motion is with no doubt one of the most important elements of a patient's clinical image. It describes recent achievements in vision-based detection, analysis and recognition of human motion in epilepsy for marker-based and marker-free systems. An overview of motion-characterizing features extracted so far is presented separately. The objective is to gain existing knowledge in this field and set the route marks for the future development of an integrated decision support system for epilepsy diagnosis and disease management based on automated video analysis. This review revealed that the quantification of motion patterns of selected epileptic seizures has been studied thoroughly while the recognition of seizures is currently in its beginnings, but however feasible. Moreover, only a limited set of seizure types have been analyzed so far, indicating that a holistic approach addressing all epileptic syndromes is still missing.
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Affiliation(s)
- Matthew Pediaditis
- Foundation for Research and Technology - Hellas, Biomedical Informatics Laboratory, 100 Nikolaou Plastira str., Vassilika Vouton, Heraklion, Crete GR 700 13, Greece.
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Peixoto-Santos JE, Galvis-Alonso OY, Velasco TR, Kandratavicius L, Assirati JA, Carlotti CG, Scandiuzzi RC, Serafini LN, Leite JP. Increased metallothionein I/II expression in patients with temporal lobe epilepsy. PLoS One 2012; 7:e44709. [PMID: 23028585 PMCID: PMC3445538 DOI: 10.1371/journal.pone.0044709] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 08/07/2012] [Indexed: 12/15/2022] Open
Abstract
In the central nervous system, zinc is released along with glutamate during neurotransmission and, in excess, can promote neuronal death. Experimental studies have shown that metallothioneins I/II (MT-I/II), which chelate free zinc, can affect seizures and reduce neuronal death after status epilepticus. Our aim was to evaluate the expression of MT-I/II in the hippocampus of patients with temporal lobe epilepsy (TLE). Hippocampi from patients with pharmacoresistant mesial temporal lobe epilepsy (MTLE) and patients with TLE associated with tumor or dysplasia (TLE-TD) were evaluated for expression of MT-I/II, for the vesicular zinc levels, and for neuronal, astroglial, and microglial populations. Compared to control cases, MTLE group displayed widespread increase in MT-I/II expression, astrogliosis, microgliosis and reduced neuronal population. In TLE-TD, the same changes were observed, except that were mainly confined to fascia dentata. Increased vesicular zinc was observed only in the inner molecular layer of MTLE patients, when compared to control cases. Correlation and linear regression analyses indicated an association between increased MT-I/II and increased astrogliosis in TLE. MT-I/II levels did not correlate with any clinical variables, but MTLE patients with secondary generalized seizures (SGS) had less MT-I/II than MTLE patients without SGS. In conclusion, MT-I/II expression was increased in hippocampi from TLE patients and our data suggest that it is associated with astrogliosis and may be associated with different seizure spread patterns.
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Affiliation(s)
- José Eduardo Peixoto-Santos
- Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - Orfa Yineth Galvis-Alonso
- Department of Molecular Biology, São José do Rio Preto Medical School, São José do Rio Preto – São Paulo, Brazil
| | - Tonicarlo Rodrigues Velasco
- Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - Ludmyla Kandratavicius
- Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - João Alberto Assirati
- Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - Carlos Gilberto Carlotti
- Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - Renata Caldo Scandiuzzi
- Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - Luciano Neder Serafini
- Department of Pathology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
| | - João Pereira Leite
- Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto – São Paulo, Brazil
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Cunha JPS, Paula LM, Bento VF, Bilgin C, Dias E, Noachtar S. Movement quantification in epileptic seizures: A feasibility study for a new 3D approach. Med Eng Phys 2012; 34:938-45. [DOI: 10.1016/j.medengphy.2011.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 10/11/2011] [Accepted: 10/31/2011] [Indexed: 10/14/2022]
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Feddersen B, Remi J, Kilian M, Vercueil L, Deransart C, Depaulis A, Noachtar S. Is ictal dystonia associated with an inhibitory effect on seizure propagation in focal epilepsies? Epilepsy Res 2012; 99:274-80. [DOI: 10.1016/j.eplepsyres.2011.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 12/04/2011] [Accepted: 12/11/2011] [Indexed: 10/14/2022]
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Rémi J, Wagner P, O’Dwyer R, Silva Cunha JP, Vollmar C, Krotofil I, Noachtar S. Ictal head turning in frontal and temporal lobe epilepsy. Epilepsia 2011; 52:1447-51. [DOI: 10.1111/j.1528-1167.2011.03076.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vendrame M, Zarowski M, Alexopoulos AV, Wyllie E, Kothare SV, Loddenkemper T. Localization of pediatric seizure semiology. Clin Neurophysiol 2011; 122:1924-8. [PMID: 21474374 DOI: 10.1016/j.clinph.2011.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 02/03/2011] [Accepted: 03/02/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between semiology of seizures in children and adolescents to the corresponding EEG localization. METHODS Charts of 225 consecutive pediatric epilepsy patients undergoing Video-EEG monitoring (VEM) over 2 years were reviewed. Seizure semiology recorded during VEM was classified according to ILAE seizure semiology terminology and EEG localization, and analyzed based on onset as defined by the EEG data (generalized, frontal, temporal, parietal, occipital or multilobar). RESULTS A total of 1008 seizures were analyzed in 225 children (mean age 8.5 years, range 0-20), with 50% boys. Auras and seizures with automatisms arose predominantly from the temporal lobes (p<0.001). Tonic, clonic and tonic-clonic seizures had most commonly generalized onset (p<0.001). Hypomotor seizures were most frequently seen from the frontal lobes (p<0.001). Hypermotor seizures had most commonly temporal lobe or multiple lobe onset (p<0.001 and p<0.05 respectively). Atonic, myoclonic seizures and epileptic spasms had almost exclusively a generalized onset (p<0.001). CONCLUSIONS Different seizure semiologies relate to specific brain regions, with overlap between focal and generalized semiological seizure types, as identified electrographically. SIGNIFICANCE Semiology of seizures can provide important information for epilepsy localization, and should not be overlooked, especially in patients undergoing pre-surgical evaluation. Separation of clinical seizure description and EEG findings may be useful, in particular when only incomplete information is available. i.e. during the first office visit.
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Affiliation(s)
- Martina Vendrame
- Epilepsy and Clinical Neurophysiology, Children's Hospital Boston, Boston, MA 02115, United States
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Localizing and lateralizing features of auras and seizures. Epilepsy Behav 2011; 20:160-6. [PMID: 20926350 DOI: 10.1016/j.yebeh.2010.08.034] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 08/31/2010] [Indexed: 11/23/2022]
Abstract
The symptomatology of auras and seizures is a reflection of activation of specific parts of the brain by the ictal discharge, the location and extent of which represent the symptomatogenic zone. The symptomatogenic zone is presumably, though not necessarily, in close proximity to the epileptogenic zone, the area responsible for seizure generation, the complete removal or disconnection of which is necessary for seizure freedom. Knowledge about the symptomatogenic zone in focal epilepsy is acquired through careful video/EEG monitoring and behavioral correlation of seizures and electrical stimulation studies. Ictal symptomatogy provides important lateralizing and/or localizing information in the presurgical assessment of epilepsy surgery candidates. As the initial symptoms of epileptic seizures, many types of auras have highly significant localizing or lateralizing value. Similarly, motor signs during focal and secondary generalized seizures, language manifestations, and autonomic features offer reliable clues to the delineation of the epileptogenic zone. Some focal epilepsies (e.g., neocortical temporal lobe epilepsy, insular lobe epilepsy, temporal-plus epilepsies, and parieto-occipital lobe epilepsy) generate seizure manifestations that mimic temporal lobe epilepsy, potentially contributing to surgical failure. To optimize surgical outcome, careful interpretation of ictal symptomatology in conjunction with other components of the presurgical evaluation is required.
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Mirzadjanova Z, Peters AS, Rémi J, Bilgin C, Silva Cunha JP, Noachtar S. Significance of lateralization of upper limb automatisms in temporal lobe epilepsy: A quantitative movement analysis. Epilepsia 2010; 51:2140-6. [DOI: 10.1111/j.1528-1167.2010.02599.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Garcia-Cairasco N, Dal-Cól ML, Bertti P. Quantitative movement trajectory analysis and neuroethology in clinical epileptology. Epilepsy Behav 2009; 15:266-7. [PMID: 19249386 DOI: 10.1016/j.yebeh.2009.02.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Accepted: 02/20/2009] [Indexed: 10/21/2022]
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Noachtar S, Peters AS. Semiology of epileptic seizures: a critical review. Epilepsy Behav 2009; 15:2-9. [PMID: 19236941 DOI: 10.1016/j.yebeh.2009.02.029] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 02/19/2009] [Indexed: 10/21/2022]
Abstract
Epileptic seizures are characterized by a variety of symptoms. Their typical semiology served for a long time as the major tool to classify epilepsy syndromes. The signs and symptoms of epileptic seizures include the following spheres: sensorial sphere, consciousness, motor and autonomic spheres. Most seizures involve more than one sphere, however, some like for instance aura (sensorial sphere) or dialeptic seizures (consciousness) involve only one sphere. The predominant clinical features of a seizure determines the seizure classification. The following review gives an introduction into the semiological seizure classification. This approach enables us to better identify the epileptogenic zone of our patients and to choose the most effective medical or surgical treatment.
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Affiliation(s)
- Soheyl Noachtar
- Epilepsy Center, Department of Neurology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany.
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Yang X, Chen L, Liu Y, Zeng D, Tang Y, Yan B, Lin X, Liu L, Xu H, Zhou D. Motor trajectories in automatisms and their quantitative analysis. Epilepsy Res 2009; 83:97-102. [DOI: 10.1016/j.eplepsyres.2008.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 09/17/2008] [Accepted: 09/28/2008] [Indexed: 10/21/2022]
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Chen L, Yang X, Liu Y, Zeng D, Tang Y, Yan B, Lin X, Liu L, Xu H, Zhou D. Quantitative and trajectory analysis of movement trajectories in supplementary motor area seizures of frontal lobe epilepsy. Epilepsy Behav 2009; 14:344-53. [PMID: 19100340 DOI: 10.1016/j.yebeh.2008.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 10/19/2008] [Accepted: 11/14/2008] [Indexed: 11/17/2022]
Abstract
The objectives of this study were to quantitatively analyze the movement trajectories of four types of supplementary motor area (SMA) seizures (hyperkinetic, tonic posturing, fencing posture, tonic head turning), and to compare the movement trajectories of SMA seizures with those of temporal lobe seizures and psychogenic nonepileptic seizures. Ten video/EEG recordings of each type of seizure were obtained. Imaging data collected by video/EEG monitoring were transformed into a digital matrix with image processing software and then transformed into a movement trajectory curve with MATLAB 6.5 software. From these movement trajectories, amplitude, frequency, proximal/distal limb amplitude ratios, and shoulder/abdominal amplitude ratios measurements were calculated. One-way ANOVA revealed statistically significant differences in average amplitude, as well as proximal/distal limb amplitude ratios, in SMA seizures when compared with those of temporal lobe seizures and psychogenic nonepileptic seizures. This study proved the feasibility of quantitative analysis of SMA seizures and suggests it should be further evaluated for its capability to distinguish different seizure semiologies for the diagnosis of epilepsy.
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Affiliation(s)
- Lei Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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