ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00858.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00859.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00860.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Thirty‐two patients with juvenile myoclonic epilepsy (JME) were studied to evaluate the seizure prognosis. The response to antiepileptic drugs ww excellent in 68%, but the patients, who had much more focal discharges on EEG and were sensitive to neuropsychological EEG activations at the beginning of treatment, had an unfavorable outcome. A combination of absence seizure alone resulted in the excellent prognosis for both absence and myoclonic seizures, and a combination of generalized tonic‐clonic seizure on awakening related to rare myoclonic seizures. These findings suggest that the outcome of JME would be predicted by the EEG abnormality and the combination of the other types of seizures, which are probably determined by the pathophysiology at the beginning of treatm

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00861.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Twenty‐nine children with childhood epilepsy characterized by frequent grand mal (generalized tonic‐clonic) seizures in spite of maximal doses of antiepileptic drugs and by an early onset of seizures (before1:year of age) were followed up for more than5:years. The children were divided into3:groups: severe myoclonic epilepsy in infancy (SME), no SME, and intractable childhood epilepsy with generalized tonic‐clonic seizures (GTC). In all the3:groups, the grand mal seizures persisted, whereas the other types of seizures tended to disappear as the patients aged, and the prognosis for mental development was poor. In the majority of cases in all the3:groups, the waking grand mal seizures altered to sleep grand mal seizures with aging. Two pairs of monozygotic twins with SME suggested that genetic factors play a role in this epileptic syndrome. Intractable childhood epilepsy with GTC is distinguished by the absence of other types of generalized seizures. It cannot be regarded as an epileptic syndrome, but its pathogenesis and treatment require further st

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00862.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Fifty‐four idiopathic status convulsivus (SC) cases were followed prospectively for a period between5:and21:years, the average being13:years. Three‐fourths of the cases had no residuals. There were two patterns of subsequent epilepsy; 1) complex partial seizures (CPS) with or without secondarily generalization (GTS) developed 4.3 ± 3.5 years after febrile SC, 2) unilateral seizures or CPS ± GTS developed 1.2 ± 1.0 years after afebrile SC. The seizure prognosis of these cases was good except for some cases in the former group. There have been two kinds of theories regarding SC and epilepsy until now. One was derived from retrospective studies: SC and/or complex febrile convulsion (FC) were considered the main causes of temporal lobe epilepsy (TLE) producing mesial temporal sclerosis (MTS). Another was derived from prospective studies, in which the relation between FC and TLE was considered weak. Our results revealed that6:cases (15%) out of30:febrile SC developed epilepsy, and that five of those six cases were diagnosed as CPS. Three of5:CPS cases were diagnosed as TLE. Recently the seizure prognosis of operative therapy for TLE—especially the MTS type—has been very favorable. Furthermore, it has become easy to And MTS by Magnetic Resonance Imaging (MRI). So, we emphasize that a precise follow‐up study of SC using MRI, EEG, etc., is important in deciding the appropriate therapy for TLE, as well as in the study of the pathoge

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00863.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00864.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00865.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00866.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:The omission of invasive long‐term monitoring before surgical resection in patients with epilepsy should be permitted only for those in whom the epileptogenic focus is presumed to localize unilaterally in the mesial aspect of the temporal lobe. The localization may well be confirmed through noninvasive measures. Retrospective analyses of data obtained from noninvasive investigations (scalp‐recorded and sphenoidal EEG, neu‐rolmages, and electroclinical seizure manifestations) were carried out in58:patients. The localization of their epileptogenic focus was subsequently confirmed by the implantation of both intracerebral and subdural electrodes; the focus had an amygdalohippocampal origin in41:patients and a lateral temporal origin in17:patients. From the comparison of noninvasive Andings between these two groups, we propose the following indispensable conditions for omitting an invasive evaluation: 1. Appearance of focal epileptic discharges unilaterally in the sphenoidal lead observed during the simple phase of partial seizures, or unilateral discharges with predominancy in the sphenoidal lead during the early phase of complex partial seizures. 2. Interictal spikes on scalp‐recorded EECs localizing unilaterally in the anterior region of the temporal lobe, and if bilaterally independent, presenting with unilateral predominancy in a ratio of greater than 41. 3. Presence of autonomic signs in the initial phase of signal symptoms. 4. Neuroimaging Andings in the mesial temporal region: elongated T2 on MRI and hippocampal atrophy, or a tumorous lesion. The lateralhation conforms to interictal and ictal paroxysmal EEC findings. There were8:patients with seizures of amygdalohippocampal origin who satisfied all the indispensable condition, but not a single patient with seizures of lateral temporal origin. Thus, the conditions we propose are surely useful for determining whether patienta with lateral temporal seizures should be excluded from invasive long‐term monitoring before surgical

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00867.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY