Extratemporal Epilepsy Eishi Asano, MD, PhD, MS Associate Professor of Pediatrics and Neurology Wayne State University School of Medicine Director, Electroneurodiagnostic Lab Children's Hospital of Michigan
- Extratemporal lobe epilepsy - Idiopathic - Symptomatic Focal epilepsy - Extratemporal lobe epilepsy - Idiopathic - Symptomatic - Temporal lobe epilepsy Generalized epilepsy two types?
Idiopathic Childhood Epilepsy with Central-Temporal Spikes (Benign Rolandic Epilepsy)
Idiopathic Childhood Epilepsy with Central-Temporal Spikes (Benign Rolandic Epilepsy) Fp1-F7 F7-T3 T3-T5 T5-O1 Fp1-F3 F3-C3 C3-P3 P3-O1 Fz-Cz Cz-Pz Fp2-F4 F4-C4 C4-P4 P4-O2 Fp2-F8 F8-T4 T4-T6 T6-O2
Idiopathic Childhood Epilepsy with Central-Temporal Spikes (Benign Rolandic Epilepsy) is characterized by …..? Age Seizure semiology EEG Neuropsychologically? 3 – 10 yr Facial twitching during sleep > sGTC Central-Temporal spike Pt may have impairment.
Idiopathic Childhood Epilepsy with Occipital spikes (Benign Occipital Epilepsy) Do occipital spikes arise from the left side or the right side? What additional montage will help you?
Idiopathic Childhood Epilepsy with Occipital Spikes (Benign Occipital Lobe Epilepsy) is characterized by …..? Age Seizure semiology EEG Neuropsychologically? 3 – 10 yr Visual Aura, Eye deviation, Version, Vomiting > sGTC Occipital spike Pt may have impairment.
Extratemporal lobe epilepsy Focal epilepsy Extratemporal lobe epilepsy -Frontal lobe epilepsy -Parietal lobe epilepsy -Occipital lobe epilepsy -Multilobar epilepsy Multilobar Epilepsy Symptomatic Generalized Epilepsy (such as Lennox-Gastaut syndrome)
Seizure video
Frontal lobe epilepsy stereotyped semiology, occurrence during sleep, brief duration (often <30 seconds), rapid secondary generalization, prominent motor manifestations, and complex automatisms.
Supplementary motor area (SMA) unilateral or asymmetric bilateral tonic posturing vocalization, somatosensory aura; complex automatisms such as kicking, responsiveness often preserved
Primary motor cortex simple partial motor seizures with clonic or myoclonic movements preserved consciousness secondary generalization is frequent
Medial frontal, cingulate, orbitofrontal regions Complex behavioral events (bizarre) gestural automatisms; strong emotional feelings; hypermotor activities (pelvic thrusting, pedaling, or thrashing, often accompanied by vocalizations or laughter/crying)
Autosomal dominant FLE Brief nocturnal motor seizures nicotinic acetylcholine receptor genes (nAChR alpha4 and beta2 subunits)
Parietal lobe epilepsy Somatosensory aura Vertigo aura Visual aura Then CPS or GTC
Parietal lobe epilepsy Somatosensory aura Vertigo aura Visual aura Then CPS or GTC
Occipital lobe epilepsy Idiopathic Childhood Epilepsy with Occipital Spikes (Benign Occipital Lobe Epilepsy) is characterized by …..? Age Seizure semiology EEG Neuropsychologically? 3 – 10 yr Visual Aura, Eye deviation, Version, Vomiting Then sGTC Occipital spike Pt may have impairment.