Emel UR ÖZÇELİK
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroloji ve Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)
Dilek ATAKLI
(Bakırköy Sağlık Bilimleri Üniversitesi, Nöroloji Anabilim Dalı, Prof. Dr. Mazhar Osman Ruh Sağlığı ve Nöroloji Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)
Nermin Görkem ŞİRİN
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroloji ve Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)
Ayhan KÖKSAL
(Bakırköy Sağlık Bilimleri Üniversitesi, Nöroloji Anabilim Dalı, Prof. Dr. Mazhar Osman Ruh Sağlığı ve Nöroloji Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)
Betül BAYKAN
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, nöroloji ve klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)
Yıl: 2021Cilt: 27Sayı: 1ISSN: 1300-7157Sayfa Aralığı: 52 - 61İngilizce

89 0
Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods
Objectives: Epileptogenesis is still not clearly understood. Therefore, there is an inevitable need for research that investigates triggers for reflex seizures and neuropsychological activation (NPA) methods using electroencephalography (EEG) in different epileptic syndromes. In this regard, we aimed to examine the characteristics and frequency of triggers for reflex seizures as well as changes in the frequency of epilepti-form discharges (EDs), according to the stimulus in patients with generalized genetic epilepsy (GGE) and drug- resistant focal epilepsy (FE) by performing a comparative study with a survey and a neuropsychological EEG activation method, besides routine EEG.Methods: A detailed and structured survey questioning seizure triggers was applied to patients with FE and GGE. Afterward, the changes in EDs in juvenile myoclonic epilepsy (JME), absence epilepsy (AE), and resistant FE groups were examined using NPA methods with EEG.Results: The most frequently reported triggers in all patient groups (n=66) were sleep deprivation (68.2%), stress (65.3%), fatigue/physical stress (53%), awakening (42.4%), and light stimuli (25.8%). There was no significant difference between the JME (n=34), AE (n=16), and resistant FE (n=16) groups in terms of either the triggering or inhibition of EDs in EEG by conventional activation and NPA methods. While the triggering of EDs occurred in 24% of patients by hyperventilation and in 18.1% of patients by intermittent photic stimulation, a similar triggering rate was detected in 21.2% of patients by NPA methods. In addition, while the results of the conventional EEG activation methods were negative, a triggered ED was observed in six patients during NPA (11%). Only two patients showed an inhibition by the NPA methods. Four patients had EDs on their EEGs during the NPA methods associated with triggers reported in the questionnaire.Conclusion: In 11% of patients, while an ED was not seen in conventional methods, we observed that ED triggering occurred with the NPA methods. Planning the NPA methods for specific triggers during EEG recordings by prior questioning on the seizure triggers of the patients and applying NPA as an additional triggering method, especially for patients who do not have EDs in EEG with standard activation methods, may be beneficial in terms of the correct diagnosis.
DergiAraştırma MakalesiErişime Açık
  • 1. Engel J Jr; International League Against Epilepsy (ILAE). A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia 2001;42(6):796−803.
  • 2. Xue LY, Ritaccio AL. Reflex seizures and reflex epilepsy. Am J Electroneurodiagnostic Technol 2006;46(1):39−48.
  • 3. Kasteleijn-Nolst Trenité D, Rubboli G, Hirsch E, Martins da Silva A, Seri S, Wilkins A, et al. Methodology of photic stimulation revisited: updated European algorithm for visual stimulation in the EEG laboratory. Epilepsia 2012;53(1):16−24.
  • 4. Irmen F, Wehner T, Lemieux L. Do reflex seizures and spontaneous seizures form a continuum? Triggering factors and possible common mechanisms. Seizure 2015;25:72−9.
  • 5. Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy Behav 2014;33:101−5.
  • 6. Lunardi MDS, Sukys-Claudino L, Guarnieri R, Walz R, Lin K. Seizure precipitants and inhibiting factors in mesial temporal lobe epilepsy. J Neurol Sci 2011;308(1-2):21−4.
  • 7. Italiano D, Ferlazzo E, Gasparini S, Spina E, Mondello S, Labate A, et al. Generalized versus partial reflex seizures: a review. Seizure 2014;23(7):512−20.
  • 8. Walker MC, White HS, Sander JWAS. Disease modification in partial epilepsy. Brain 2002;125(9):1937−50.
  • 9. Wolf P, Beniczky S. Understanding ictogenesis in generalized epilepsies. Expert Rev Neurother. 2014 Jul;14(7):787−98.
  • 10. Matsuoka H, Takahashi T, Sasaki M, Matsumoto K, Yoshida S, Numachi Y, et al. Neuropsychological EEG activation in patients with epilepsy. Brain 2000;123(2):318−30.
  • 11. Beniczky S, Guaranha MS, Conradsen I, Singh MB, Rutar V, Lorber B, et al. Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: an investigation of reflex epileptic traits. Epilepsia 2012;53(5):832−9.
  • 12. Guaranha MS, da Silva Sousa P, de Araújo-Filho GM, Lin K, Guilhoto LM, Caboclo LO, et al. Provocative and inhibitory effects of a video-EEG neuropsychologic protocol in juvenile myoclonic epilepsy. Epilepsia 2009;50(11):2446−55.
  • 13. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017;58(4):512−21.
  • 14. Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51(6):1069−77.
  • 15. Maulsby RL. Some guidelines for assessment of spikes and sharp waves in EEG tracings. Am J EEG Technol 1971;11(1):3-16.
  • 16. Mayer TA, Schroeder F, May TW, Wolf PT. Perioral reflex myoclonias: a controlled study in patients with JME and focal epilepsies. Epilepsia 2006;47(6):1059−67.
  • 17. Karachristianou S, Bostantjopoulou S, Katsarou Z, Kazis A. Neuropsychological EEG activation in patients with juvenile myoclonic epilepsy. Funct Neurol 2004;19(3):185−9.
  • 18. Wolf P, Goosses R. Relation of photosensitivity to epileptic syndromes. J Neurol Neurosurg Psychiatry 1986;49(12):1386−91.
  • 19. Mameniškienė R, Wolf P. Precipitation and inhibition of seizures in focal epilepsies. Expert Rev Neurother 2018;18(4):275−87.
  • 20. InoueY. Epilepsy with praxis-induced epilepsy. In: Wolf P, editor. Epileptic Seizures and Syndromes. London: John Libbey; 1994. p. 81−92.
  • 21. Yacubian EM, Wolf P. Praxis induction. Definition, relation to epilepsy syndromes, nosological and prognostic significance. A focused review. Seizure 2014;23(4):247−51.
  • 22. Abarrategui B, Parejo-Carbonell B, García García ME, Gil-Nagel A, García-Morales I. Praxis induction and its relationship with cognition in genetic generalized epilepsy. Epilepsy Behav 2020;102:106638.
  • 23. Baldin E, Hauser WA, Buchhalter JR, Hesdorffer DC, Ottman R. Utility of EEG Activation Procedures in Epilepsy: A Population-Based Study. J Clin Neurophysiol 2017;34(6):512−9.
  • 24. Holmes MD, Quiring J, Tucker DM. Evidence that juvenile myoclonic epilepsy is a disorder of frontotemporal corticothalamic networks. Neuroimage 2010;49(1):80–93.
  • 25. Guaranha MS, Garzon E, Buchpiguel CA, Tazima S, Yacubian EM, Sakamoto AC. Hyperventilation revisited: physiological effects and efficacy on focal seizure activation in the era of video-EEG monitoring. Epilepsia 2005;46(1):69–75.
  • 26. Poleon S, Szaflarski JP. Photosensitivity in generalized epilepsies. Epilepsy Behav 2017;68:225–33.
  • 27. Lunardi MS, Lin K, Mameniškienė R, Beniczky S, Bogacz A, Braga P, et al. Olfactory stimulation induces delayed responses in epilepsy. Epilepsy and Behav 2016;61:90–6.

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