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Electroclinical characterization and classification of symptomatic epilepsies with very early onset by multiple correspondence analysis.
MedLine Citation:
PMID:  20696553     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To characterize very early onset symptomatic epilepsies electroclinically, to identify meaningful factors to delineate epilepsy syndromes under this category, and to test validity of the current syndromic organization of these epilepsies by the International League Against Epilepsy (ILAE).
METHODS: Subjects were 38 epileptic patients with seizure onset before 3 months of age. We investigated the age of seizure onset, seizure types, myoclonus, EEG features, neuroimaging studies, outcome of seizures and development. We performed multiple correspondence analysis (MCA) to reveal associations among these characteristics and to find important characteristics to divide this epilepsy group into subgroups.
RESULTS: Very early onset epilepsies were characterized by partial seizures and epileptic spasms, especially occurring in combination as a single ictal event (combined seizures), and poor outcome. Suppression-burst (SB), hypsarrhythmia, EEG asymmetry and structural brain abnormalities were common. MCA demonstrated that presence or absence of SB was the most meaningful factor to separate this group into subgroups. MCA on the subgroup with SB revealed a subset with early-onset spasms, partial seizures with single focus, no myoclonus, SB during wakefulness and sleep, no EEG asynchrony, hypsarrhythmia and combined seizures, and another subset with late-onset spasms, partial seizures with multiple foci, myoclonus, EEG asynchrony, no combined seizures, SB during sleep only, no EEG asymmetry, no structural abnormality and no hypsarrhythmia. These corresponded to Ohtahara syndrome and early myoclonic encephalopathy, respectively.
CONCLUSIONS: Very early onset symptomatic epilepsies have the electroclinical characteristics distinct from those with later onset. This study supported the current ILAE organization on this epilepsy group from statistic approach.
Authors:
Tomoyuki Akiyama; Katsuhiro Kobayashi; Yoko Ohtsuka
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Publication Detail:
Type:  Journal Article     Date:  2010-08-08
Journal Detail:
Title:  Epilepsy research     Volume:  91     ISSN:  1872-6844     ISO Abbreviation:  Epilepsy Res.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703089     Medline TA:  Epilepsy Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  232-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
Department of Child Neurology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. tomoyuki.akiyama@sickkids.ca
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