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Magnetoencephalography localizing spike sources of atypical benign partial epilepsy.
Brain Dev. 2014 Jan; 36(1):21-7.BD

Abstract

RATIONALE

Atypical benign partial epilepsy (ABPE) is characterized by centro-temporal electroencephalography (EEG) spikes, continuous spike and waves during sleep (CSWS), and multiple seizure types including epileptic negative myoclonus (ENM), but not tonic seizures. This study evaluated the localization of magnetoencephalography (MEG) spike sources (MEGSSs) to investigate the clinical features and mechanism underlying ABPE.

METHODS

We retrospectively analyzed seizure profiles, scalp video EEG (VEEG) and MEG in ABPE patients.

RESULTS

Eighteen ABPE patients were identified (nine girls and nine boys). Seizure onset ranged from 1.3 to 8.8years (median, 2.9years). Initial seizures consisted of focal motor seizures (15 patients) and absences/atypical absences (3). Seventeen patients had multiple seizure types including drop attacks (16), focal motor seizures (16), ENM (14), absences/atypical absences (11) and focal myoclonic seizures (10). VEEG showed centro-temporal spikes and CSWS in all patients. Magnetic resonance imaging (MRI) was reported as normal in all patients. MEGSSs were localized over the following regions: both Rolandic and sylvian (8), peri-sylvian (5), peri-Rolandic (4), parieto-occipital (1), bilateral (10) and unilateral (8). All patients were on more than two antiepileptic medications. ENM and absences/atypical absences were controlled in 14 patients treated with adjunctive ethosuximide.

CONCLUSION

MEG localized the source of centro-temporal spikes and CSWS in the Rolandic-sylvian regions. Centro-temporal spikes, Rolandic-sylvian spike sources and focal motor seizures are evidence that ABPE presents with Rolandic-sylvian onset seizures. ABPE is therefore a unique, age-related and localization-related epilepsy with a Rolandic-sylvian epileptic focus plus possible thalamo-cortical epileptic networks in the developing brain of children.

Authors+Show Affiliations

Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.Department of Pediatrics, Tohoku University School of Medicine, Sendai, Miyagi, Japan.Department of Neurology, National Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.Department of Neurosurgery, National Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Neurology Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore.Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: hiotsubo@rogers.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23384398

Citation

Shiraishi, Hideaki, et al. "Magnetoencephalography Localizing Spike Sources of Atypical Benign Partial Epilepsy." Brain & Development, vol. 36, no. 1, 2014, pp. 21-7.
Shiraishi H, Haginoya K, Nakagawa E, et al. Magnetoencephalography localizing spike sources of atypical benign partial epilepsy. Brain Dev. 2014;36(1):21-7.
Shiraishi, H., Haginoya, K., Nakagawa, E., Saitoh, S., Kaneko, Y., Nakasato, N., Chan, D., & Otsubo, H. (2014). Magnetoencephalography localizing spike sources of atypical benign partial epilepsy. Brain & Development, 36(1), 21-7. https://doi.org/10.1016/j.braindev.2012.12.011
Shiraishi H, et al. Magnetoencephalography Localizing Spike Sources of Atypical Benign Partial Epilepsy. Brain Dev. 2014;36(1):21-7. PubMed PMID: 23384398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetoencephalography localizing spike sources of atypical benign partial epilepsy. AU - Shiraishi,Hideaki, AU - Haginoya,Kazuhiro, AU - Nakagawa,Eiji, AU - Saitoh,Shinji, AU - Kaneko,Yutaka, AU - Nakasato,Nobukazu, AU - Chan,Derrick, AU - Otsubo,Hiroshi, Y1 - 2013/02/04/ PY - 2012/09/25/received PY - 2012/12/24/revised PY - 2012/12/25/accepted PY - 2013/2/7/entrez PY - 2013/2/7/pubmed PY - 2014/8/19/medline KW - Atypical absence KW - Centro-temporal spike KW - Continuous spike and waves during sleep KW - Epileptic negative myoclonus KW - Focal seizure KW - Secondary bilateral synchrony SP - 21 EP - 7 JF - Brain & development JO - Brain Dev. VL - 36 IS - 1 N2 - RATIONALE: Atypical benign partial epilepsy (ABPE) is characterized by centro-temporal electroencephalography (EEG) spikes, continuous spike and waves during sleep (CSWS), and multiple seizure types including epileptic negative myoclonus (ENM), but not tonic seizures. This study evaluated the localization of magnetoencephalography (MEG) spike sources (MEGSSs) to investigate the clinical features and mechanism underlying ABPE. METHODS: We retrospectively analyzed seizure profiles, scalp video EEG (VEEG) and MEG in ABPE patients. RESULTS: Eighteen ABPE patients were identified (nine girls and nine boys). Seizure onset ranged from 1.3 to 8.8years (median, 2.9years). Initial seizures consisted of focal motor seizures (15 patients) and absences/atypical absences (3). Seventeen patients had multiple seizure types including drop attacks (16), focal motor seizures (16), ENM (14), absences/atypical absences (11) and focal myoclonic seizures (10). VEEG showed centro-temporal spikes and CSWS in all patients. Magnetic resonance imaging (MRI) was reported as normal in all patients. MEGSSs were localized over the following regions: both Rolandic and sylvian (8), peri-sylvian (5), peri-Rolandic (4), parieto-occipital (1), bilateral (10) and unilateral (8). All patients were on more than two antiepileptic medications. ENM and absences/atypical absences were controlled in 14 patients treated with adjunctive ethosuximide. CONCLUSION: MEG localized the source of centro-temporal spikes and CSWS in the Rolandic-sylvian regions. Centro-temporal spikes, Rolandic-sylvian spike sources and focal motor seizures are evidence that ABPE presents with Rolandic-sylvian onset seizures. ABPE is therefore a unique, age-related and localization-related epilepsy with a Rolandic-sylvian epileptic focus plus possible thalamo-cortical epileptic networks in the developing brain of children. SN - 1872-7131 UR - https://www.unboundmedicine.com/medline/citation/23384398/Magnetoencephalography_localizing_spike_sources_of_atypical_benign_partial_epilepsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0387-7604(13)00004-1 DB - PRIME DP - Unbound Medicine ER -