ObjectiveTo identify the clinical significance of epileptic eye movement for localization of posterior epileptic seizures. MethodsThere were 12 posterior epileptic patients, who were undertaken the detailed presurgical evaluation and ictal SEEG recording, and the epileptogenic zone of whom was confirmed restricted within posterior cortex through the boarder of epileptic cortical resection and the result of epileptic surgery, included in the research. ResultsThe cluster analysis of posterior cortical area of interest showed that parieto-occipital sulcus (POS) with the adjacent cortical areas belonged to the Medial Group; intraparietal sulcus (IPS) with the adjacent areas belonged to the Intermediate Group; and the Lateral Group included anterior occipital sulcus (AOS) and posterior temporal cortex. Eyes forced stare had the significant correlation with IPS, POS and related cortical group. Contraversive eye deviation had no significant correlation with cortical eye field with the related cortical areas. ConclusionsForced eye stare was significant eye movement in posterior epilepsy, and had significant correlation with IPS and POS. Ipsiversive eye deviation and convergence binocular movement were rare semiology in posterior epilepsy, and AOS had significant correlation with the two type of epileptic eyes movement.
ObjectiveTo study the clinical characteristics of patients onset epilepsy Dentatorubral-pallidoluysian atropy (DRPLA) in Epilepsy Center of Guangdong 999 Brain Hospital and improve understanding of the disease. MethodsCollected five patients from August 2014 to August 2016 in Guangdong 999 Brain Hospital, whom diagnosed through genetic testing of DRPLA, analysed their disease course, family history, video-EEG, brain MRI and treatment data. ResultsDRPLA performed as neurodegenerative diseases, and epilepsy population mainly performed as progressive myoclonic epilepsy (Progressive myoclonus epilepsy, PME). ConclusionDRPLA is autosomal dominant neurodegenerative disease. In patients with cerebellar atrophy, neurological regression, ataxia, drug refractory epilepsy, it is recommended routinely to detect ATN1 gene, so that timely diagnosis and genetic counseling.
ObjectiveTo analyse the seizure semeiology of MRI negative insular epilepsy.MethodsA case of patient with insular epilepsy who presented in Epileptic Center, Guangdong 999 Brain Hospital was collected. Related literatures were thoroughly reviewed.ResultsThe patient was diagnosised as insular epilepsy by SEEG and postoperative pathology reported focal cortical dysplasia Ib.ConclusionsThe insula lobe is a part of the limbic system, and the seizure semeiology in insular epilepsy is varied. Seizure semeiology analysis is particularly important in the evaluation of presurgical especially in a MRI negative case. In this paper, we summarized the semeiology characteristics of various parts of insula lobe, and provided some references for the diagnosis and treatment of insular epilepsy.
ObjectiveThe time relationship between seizure semiology and epileptic discharges during focal epileptic seizures is a crucial predictor for the localization of epileptogenic zone. Low voltage fast activities (LVFA), especially gamma band oscillations, are confirmed to play a central role in ictogenesis and semiology production. In the present study, we focus on the “electro-clinical correlation” between LVFA in agranulo-dysgranular insulo-cingulate cortices and the sign of “Chapeau de gendarme (CDG)” via detailed analysis of ictal video-stereoencephalography (video-SEEG) of focal epileptic seizures. MethodsWe retrospectively analyzed the ictal video-SEEG of the 7 cases in which CDG signs were presented in habitual seizures and intracerebral electrodes were co-implanted in agranulo-dysgranular insular and cingulate cortices. We calculate the latency of LVFA in each of cortical regions of interest, agranulo-dygranular insular cortex, agranulo-dysgranular cingulate cortex, and the latency of CDG signs via visual and spectral analysis of the ictal SEEG. Moreover, Pearson correlation analysis and linear regression were used to test the time relationship between gamma band oscillations in agranulo-dysgranular insulo-cingulate cortices and generation of CDG signs. ResultsThe co-activation of LVFA occurred in agranulo-dysgranular insulo-cingulate cortices always preceded the appearance of CDG sign in all of the 69 seizures. The LVFA were confirmed as gamma band oscillations via spectral analysis of SEEG. A linear relationship between the latencies of CDG signs and the latencies of co-activation of agranulo-dysgranular insulo-cingulate cortices in gamma band was furth confirmed by Pearson correlation analysis and linear regression. ConclusionsThere is a causal relationship between the involvement of agranulo-dysgranular insulo-cingulate cortices and the generation of CDG sign, and thus the CDG sign could be view as semiological marker of activation of emotional insulo-cingulate cortex in focal epilepsy.