Document Detail

Bilateral akinetic seizures: a clinical and electroencephalographic description.
MedLine Citation:
PMID:  20662894     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The main feature of akinetic seizures is the inhibition of voluntary movements without impairment of awareness. Most clinical information about akinetic seizures has been obtained from cortical electrical stimulation studies, whereas clinical and video-electroen-cephalography (EEG) features have not been described thoroughly. We aimed to analyze clinical and EEG characteristics of bilateral akinetic seizures (BAS).
METHODS: Patients with BAS were retrospectively identified from 1,858 consecutive video-EEG studies. All patients had ictal video-EEG, comprehensive clinical evaluation, neuropsychological testing, and brain magnetic resonance imaging (MRI).
RESULTS: Ten patients (nine men) were identified; mean age was 22.5 years (range 0.3-71 years) at the time of epilepsy onset and 34.9 years (range 5-73 years) at the time of evaluation. BAS was the only seizure type in four patients. BAS consisted of sudden speech and motor arrest in eight patients, whereas in two patients seizures were characterized by abrupt freezing precipitated by gait initiation. Startle precipitated BAS in four patients. Magnetic resonance imaging (MRI) showed mesial frontal lobe lesions in six patients. Epileptiform activity was restricted to the frontal midline electrodes in all patients, with variable extension to frontal regions. In five patients, BAS were initially misdiagnosed as generalized seizures or nonepileptic events.
DISCUSSION: BAS should be considered in the differential diagnosis of patients reporting paroxysmal inability to move with preservation of awareness, bearing in mind that these seizures can occur spontaneously or be precipitated by startle. The diagnosis can be achieved with video-EEG monitoring, showing stereotyped semiology and distinctive EEG abnormalities, and is often supported by the presence of lesions involving the frontal lobes.
Rafael Toledano; Irene García-Morales; Mónica M Kurtis; Angel Pérez-Sempere; Roberto Ciordia; Antonio Gil-Nagel
Related Documents :
6968264 - Carbamazepine intoxication due to triacetyloleandomycin administration in epileptic pat...
8409564 - Natural course of jaw lesions in patients with familial adenomatosis coli (gardner's sy...
1277954 - Midline commissurotomy for the treatment of some cases of intractable epilepsy. prelimi...
8162384 - Premonitory symptoms in epilepsy.
7526774 - The shoulder-hand syndrome after stroke: a prospective clinical trial.
8746904 - Ergonovine-echo test to assess the significance of chest pain at rest without ecg changes.
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  51     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2108-15     Citation Subset:  IM    
Copyright Information:
Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.
Epilepsy Unit, Department of Neurology, Hospital Ruber Internacional, Madrid, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Age of Onset
Awareness / physiology
Brain / pathology,  physiopathology
Child, Preschool
Electroencephalography / methods,  statistics & numerical data*
Epilepsy, Generalized / diagnosis*,  physiopathology,  psychology
Functional Laterality / physiology
Magnetic Resonance Imaging
Middle Aged
Neuropsychological Tests
Retrospective Studies
Terminology as Topic
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Therapeutic time window of low-frequency stimulation at entorhinal cortex for amygdaloid-kindling se...
Next Document:  Do older adults have equitable access to specialist epilepsy services?