Clinical and eletroencephalographic differentiation of typical absences with simultaneous recording of clinical seizures with video tape: a study of 489 seizures in 18 patients / DiferenciaÃÃo clÃnica e eletroencefalogrÃfica de ausÃncias tÃpicas com registro simultÃneo de crises clÃnicas em vÃdeo: estudo de 489 crises em 18 pacientes

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

We recorded by "video-EEG" 489 typical absence seizures in 18 patients aged four years and 10 months to 64 years and 11 months. Typical absence was defined as the Seizure Classification of the International League Against Epilepsy (ILAE) (1981): "sudden onset, interruption of activities, blank stare and possible upward rotation of the eyes". Syndromic diagnosis was possible in 66.67% of the cases acording to the criteria of the Commission on Classification and Terminology of the ILAE (1989) and in 72.22% using the proposal of Panayiotopoulos (1997). In the remaining patients there was a wide spectrum of electro-clinical presentations that could not fit the described syndromic approach. In this series there were specific ictal syndromic characteristics in absence seizures as proposed by Panayiotopoulos. Patients with childhood absence epilepsy (n=7) presented more severe ictal impairment of consciousness than the ones with juvenile absence epilepsy (n=4). Interictal occipital intermittent rhythmic delta activity present in 71.43% of the cases with childhood absence epilepsy and in 25% of the juvenile form. Two patients with perioral myoclonia with absences had seizures of short duration (mean 3.85 sec). Patients with severe ictal impairment of consciousness more often presented pyknolepsy (p=0.022) and earlier seizure onset (p=0.020) than those with partial impairment. Patients with regular electrographical patterns had more frequent earlier seizure onset (p=0.038) and automatisms (p=0.023), and less often tonic-clonic seizures (p=0.002) than those with irregular spike-wave complexes. The opening phase of the ictal paroxysms (first second) showed significant higher mean compared with that of the initial phase (second to fourth second) and terminal (last three seconds) (p=0.001). The ictal frequency of the initial phase showed a higher mean compared with that of terminal phase (p=0.001)

ASSUNTO(S)

ciÃncias da saÃde apresentaÃÃes eletroclÃnicas vÃdeo-eeg epilepsia

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