BACKGROUND: Sleep-related complex motor seizures have long been considered pathognomonic features of Nocturnal Frontal Lobe Epilepsy (NFLE). In recent years, these manifestations have also been reported to have a temporal or insular origin. METHOD: We describe 40 drug-resistant epileptic patients with complex motor seizures during sleep, submitted to presurgical stereo-EEG (SEEG) evaluation and seizure-free after surgical resection of the epileptogenic zone. RESULTS: In a significant proportion (30%) of these patients, seizures arose from extra-frontal regions, including mainly the temporal lobe and the insular cortex, but also the parietal and occipital lobes. In patients with extra-frontal epilepsy, when complex motor behaviors appeared, SEEG revealed that the ictal discharge involved the cingulate and the frontal regions. Finally, at histology, Taylor's focal cortical dysplasia (TFCD) was the most common finding (90% of patients), independent of the site of seizure onset. CONCLUSION: As previously reported by other studies, this histologic substrate may be a major determinant of sleep-related seizures in drug-resistant epileptic patients.
BACKGROUND: Sleep-related complex motor seizures have long been considered pathognomonic features of Nocturnal Frontal Lobe Epilepsy (NFLE). In recent years, these manifestations have also been reported to have a temporal or insular origin. METHOD: We describe 40 drug-resistant epilepticpatients with complex motor seizures during sleep, submitted to presurgical stereo-EEG (SEEG) evaluation and seizure-free after surgical resection of the epileptogenic zone. RESULTS: In a significant proportion (30%) of these patients, seizures arose from extra-frontal regions, including mainly the temporal lobe and the insular cortex, but also the parietal and occipital lobes. In patients with extra-frontal epilepsy, when complex motor behaviors appeared, SEEG revealed that the ictal discharge involved the cingulate and the frontal regions. Finally, at histology, Taylor's focal cortical dysplasia (TFCD) was the most common finding (90% of patients), independent of the site of seizure onset. CONCLUSION: As previously reported by other studies, this histologic substrate may be a major determinant of sleep-related seizures in drug-resistant epilepticpatients.
Authors: Barbara Mostacci; Francesca Bisulli; Luca Vignatelli; Laura Licchetta; Lidia Di Vito; Claudia Rinaldi; Irene Trippi; Lorenzo Ferri; Giuseppe Plazzi; Federica Provini; Paolo Tinuper Journal: Sleep Med Date: 2014-12-16 Impact factor: 3.492
Authors: Zahari N Tchopev; Ping-Hong Yeh; Greg W Morgan; Eric Meyer; Johanna M Wolf; John M Ollinger; Gerard P Riedy; Lisa C Young Journal: Front Neurol Date: 2018-01-22 Impact factor: 4.003
Authors: Bo Jin; Wenhan Hu; Linmei Ye; Balu Krishnan; Thandar Aung; Stephen E Jones; Imad M Najm; Andreas V Alexopoulos; Kai Zhang; Junming Zhu; Jianguo Zhang; Meiping Ding; Zhong Chen; Shuang Wang; Zhong Irene Wang Journal: Front Neurol Date: 2018-02-28 Impact factor: 4.003