Santiago Galicchio1, Alberto Espeche2, Ricardo Cersosimo3, Santiago Chacon4, Beatriz Gamboni5, Javier Adi5, Lorena Fasulo6, Marcos Semprino6, Sebastian Fortini7, Pedro Cachia1, Roberto H Caraballo8. 1. Hospital de Niños Victor J Vilela de Rosario, Santa Fé, Mexico. 2. Hospital Público Materno Infantil de Salta, Argentina. 3. Centro Integral de Neurociencias (CINEU), Lomas de Zamora, Provincia de Buenos Aires, Argentina. 4. Hospital de Niños Victor J Vilela de Rosario, Santa Fé, Argentina; Clínica San Lucas, Neuquén, Argentina. 5. Hospital Pediátrico Humberto H Notti de Mendoza, Argentina. 6. Hospital de Niños Victor J Vilela de Rosario, Santa Fé, Argentina; Hospital del Niño Jesús, Tucumán, Argentina; Centro Integral de Neurociencias (CINEU), Lomas de Zamora, Provincia de Buenos Aires, Argentina; Hospital Público Materno Infantil de Salta, Argentina; Hospital de Niños Victor J Vilela de Rosario, Santa Fé, Mexico; Hospital de Pediatría Prof. Dr.Juan P Garrahan Buenos Aires, Argentina. 7. Hospital del Niño Jesús, Tucumán, Argentina. 8. Hospital de Pediatría Prof. Dr.Juan P Garrahan Buenos Aires, Argentina. Electronic address: rhcaraballo@arnet.com.ar.
Abstract
PURPOSE: We retrospectively analyzed the seizure characteristics, EEG pattern, treatment, and outcome in a series of patients with self-limited epilepsy with centrotemporal spikes (SLECTS) who presented with unusual clinical manifestations. METHOD: A retrospective, descriptive, multicenter study was conducted evaluating 46 patients with SLECTS who had seizures with an unusual semiology. We collected data from patients with SLECTS seen at eight Argentine centers between April 1998 and April 2018. RESULTS: Thirteen patients (28.2 %) had seizures with affective symptoms characterized by sudden fright and autonomic disturbances and mild impairment of consciousness. Eleven patients (24.8 %) had frequent seizures characterized by unilateral facial sensorimotor symptoms, oropharyngolaryngeal manifestations, and speech arrest with sialorrhea only when awake. Seven patients (15.3 %) started with opercular epileptic status with unilateral or bilateral clonic seizures of the mouth with speech arrest and sialorrhea when awake and during sleep. Seven patients (15.3 %) had postictal Todd's paralysis after unilateral clonic seizures with facial and limb movements lasting between 60 min and 130 min. Six patients (13 %) had negative myoclonus, two in a unilateral upper limb, two in a unilateral lower limb, and the remaining two patients had frequent falls. One patient (2.1 %) had focal sensorimotor seizures characterized by unilateral numbness in the cheeks and one upper limb, additional to unilateral facial clonic seizures, speech arrest, and sialorrhea. The remaining patient (2.1 %) had sporadic focal tonic-dystonic seizures in the left upper limb only during sleep. CONCLUSION: In our study, we found evidence of the existence of unusual clinical cases of SLECTS with typical EEG patterns and an excellent prognosis.
PURPOSE: We retrospectively analyzed the seizure characteristics, EEG pattern, treatment, and outcome in a series of patients with self-limited epilepsy with centrotemporal spikes (SLECTS) who presented with unusual clinical manifestations. METHOD: A retrospective, descriptive, multicenter study was conducted evaluating 46 patients with SLECTS who had seizures with an unusual semiology. We collected data from patients with SLECTS seen at eight Argentine centers between April 1998 and April 2018. RESULTS: Thirteen patients (28.2 %) had seizures with affective symptoms characterized by sudden fright and autonomic disturbances and mild impairment of consciousness. Eleven patients (24.8 %) had frequent seizures characterized by unilateral facial sensorimotor symptoms, oropharyngolaryngeal manifestations, and speech arrest with sialorrhea only when awake. Seven patients (15.3 %) started with opercular epileptic status with unilateral or bilateral clonic seizures of the mouth with speech arrest and sialorrhea when awake and during sleep. Seven patients (15.3 %) had postictal Todd's paralysis after unilateral clonic seizures with facial and limb movements lasting between 60 min and 130 min. Six patients (13 %) had negative myoclonus, two in a unilateral upper limb, two in a unilateral lower limb, and the remaining two patients had frequent falls. One patient (2.1 %) had focal sensorimotor seizures characterized by unilateral numbness in the cheeks and one upper limb, additional to unilateral facial clonic seizures, speech arrest, and sialorrhea. The remaining patient (2.1 %) had sporadic focal tonic-dystonic seizures in the left upper limb only during sleep. CONCLUSION: In our study, we found evidence of the existence of unusual clinical cases of SLECTS with typical EEG patterns and an excellent prognosis.
Authors: Elizabeth R Spencer; Dhinakaran Chinappen; Britt C Emerton; Amy K Morgan; Matti S Hämäläinen; Dara S Manoach; Uri T Eden; Mark A Kramer; Catherine J Chu Journal: Neuroimage Clin Date: 2022-02-07 Impact factor: 4.881