Investigation of the Relationship Between Seizure Duration and Demographic, Clinical and Radiologic Characteristics in Focal to Bilateral Tonic-Clonic Seizures

Öz

Video-electroencephalographic monitoring (VEM) is the gold standard for objectively assessing the duration of seizures' behavioral and electroencephalographic (EEG) activity. To date, EEG has clinically evaluated seizure durations in different patient groups. This study aims to reveal the relationship between demographic, clinical, and neuroimaging findings and seizure duration in epilepsy patients with focal onset bilateral tonic-clonic seizures (FBTCS) evaluated with VEM. Medical histories, neuroimaging, and clinical and ictal EEG findings obtained from VEM recordings of 58 randomly selected patients diagnosed with FBTCS in our center were retrospectively analyzed between April 2005 and January 2024. The shortest focal activity was in frontal lobe epilepsy, and the longest generalized activity was in parietooccipital lobe epilepsy. Focal activity duration was shorter in frontal and external capsule localized lesions and longer in mesial temporal localization. Focal activity duration was longer in mesial temporal sclerosis. The duration of generalized activity was longer in encephalomalacia and polymicrogyria and shorter in cortical dysplasia. Focal activity duration was shorter when lesions were accompanied by cortical atrophy. There was no correlation between the type of anti-seizure medication and seizure duration. Seizure duration may vary according to semiologic findings, radiologic features, and epilepsy syndromes. Their differences may inform the clinician about the type of epilepsy syndrome, the probability of status, and semiologic accompanying findings.

Anahtar Kelimeler

• Focal to Bilateral Tonic Clonic Seizure
• focal activity duration
• generalized activity duration
• Ictal eeg

Fokal Başlangıçlı Bilateral Tonik Klonik Nöbetlerde Nöbet Süresi ile Demografik, Klinik ve Radyolojik Özellikler Arasındaki İlişkinin Araştırılması

Öz

Video-elektroensefalografik izleme (VEM), nöbetlerin davranışsal ve elektroensefalografik (EEG) aktivite süresini objektif olarak değerlendirmek için altın standarttır. Bugüne kadar nöbet süreleri farklı hasta gruplarında klinik olarak veya EEG ile değerlendirilmiştir. Bu çalışma, VEM ile değerlendirilen fokal başlangıçlı bilateral tonik-klonik nöbet (FBTKN) tanısı olan epilepsi hastalarında, demografik, klinik ve nörogörüntüleme bulguları ile nöbet süresi arasındaki ilişkiyi ortaya koymayı amaçlamaktadır. Nisan 2005 ve Ocak 2024 tarihleri arasında merkezimizde FBTKN tanısı alan rastgele seçilmiş 58 hastanın tıbbi öyküleri, nörogörüntülemeler, VEM kayıtlarından elde edilen klinik ve iktal EEG bulguları retrospektif olarak analiz edildi. En kısa fokal aktivite frontal lob epilepsisinde ve en uzun jeneralize aktivite parietooksipital lob epilepsisindeydi. Fokal aktivite süresi frontal ve eksternal kapsül lokalizasyonlu lezyonlarda daha kısa, mezial temporal lokalizasyonda daha uzundu. Fokal aktivite süresi meziyal temporal sklerozda daha uzundu. Jeneralize aktivite süresi ensefalomalazi ve polimikrogiride daha uzun, kortikal displazide ise daha kısaydı. Lezyonlara kortikal atrofi eşlik ettiğinde fokal aktivite süresi daha kısaydı. Anti nöbet ilaç türü ile nöbet süreleri arasında herhangi bir korelasyon yoktu. Nöbet süreleri semiyolojik bulgulara, radyolojik özelliklere ve epilepsi sendromlarına göre değişebilir. Farklılıkları klinisyen için epilepsi sendromu türü, status olasığı, semiyolojik eşlik eden bulgular hakkında bilgi verici olabilir.

Anahtar Kelimeler

• Fokal Başlangıçlı Bilateral Tonik Klonik Nöbet
• Fokal aktivite süresi
• Jeneralize aktivite süresi
• İktal EEG

Kaynakça

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