Absence seizures in lesion-related epilepsy

Acta Epileptologica

Research

Ruodan Wang¹  Li Wang¹  Zhongke Wang²  Xiaoqin Sun³  Zeng He³  Xiaolin Yang³  Meihua Yang³  Miao Wang³  Chunqing Zhang³  Xianjun Shi³  Ning An³  Lihong Liu³  Shiyong Liu⁴  Hui Yang⁴  Zhifeng Wu⁵ 

[1] Department of Neurology, Second Affiliated Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba District, 400037, Chongqing, China;Department of Neurosurgery, Armed Police Hospital, 400037, Chongqing, China;Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba District, 400037, Chongqing, China;Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba District, 400037, Chongqing, China;Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, 400037, Chongqing, China;Department of Pediatrics, Second Affiliated Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba District, 400037, Chongqing, China;

关键词: Absence seizure;    Lesion-related epilepsy;    Focal epilepsy;    Lennox-Gastaut syndrome;   

DOI  :  10.1186/s42494-023-00133-4

 received in 2023-05-22, accepted in 2023-08-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn the new International League Against Epilepsy (ILAE) classification of seizure types, generalized seizures such as absence seizures (ASs) may originate from a focal point and rapidly spread to the bilaterally distributed brain network. Increasing evidence from animal and clinical studies has indicated that focal changes may occur prior to ASs; however, the relationship of ASs with epileptogenic lesions remains unclear.MethodsWe retrospectively collected and analyzed the clinical, imaging, and electrophysiological data of 16 patients who had ASs and structural lesions with seizure-free outcomes after lesion resection.ResultsIn semiology analysis, nine patients displayed focal onset; only two patients showed simple ASs, and seizure types other than ASs were observed in the remaining patients. On ictal electroencephalography (EEG), four patients showed bilateral synchronous symmetric 3 Hz generalized spike-wave discharges (GSWDs), and the remaining patients showed bilateral 1.5–2.5 Hz GSWDs. Moreover, most patients (13/16, 81.3%) exhibited focal features in addition to ASs, while interictal EEG was the same in 12 patients. Furthermore, on stereoelectroencephalogram (SEEG), 2/5 patients showed focal discharges before bilateral burst GSWDs. Additionally, all patients had structural lesions on imaging. In four typical AS patients, the lesions were located in deep brain regions. Notably, in 9 patients (9/16, 56%), the lesions were located in the posterior cortex. All patients underwent lesion resection and had seizure-free outcomes during follow-up, and intelligence quotient (IQ) also improved by 10.71 ± 3.90 one year after surgery.ConclusionsPatients with lesion-related epilepsy may present with ASs that have a focal onset and are associated with good surgical outcomes.

【 授权许可】

CC BY   
© West China Hospital 2023

【 图 表 】

Fig. 1

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