Document Detail

Fixation-off sensitivity in epilepsies other than the idiopathic epilepsies of childhood with occipital paroxysms: a 12-year clinical-video EEG study.
MedLine Citation:
PMID:  19258232     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To define the spectrum of the epileptic syndromes and epilepsies (other than the idiopathic epilepsies of childhood with occipital paroxysms) that can be associated with fixation-off sensitivity (FOS), delineate the electrographic types of FOS abnormalities and identify the patterns that can be associated with clinical seizures, and examine whether there may be a pure form of fixation-off sensitive epilepsy. METHODS: We reviewed the clinical and video EEG data of all our patients with FOS over the last 12 years. Children with idiopathic focal epilepsies and occipital EEG paroxysms were excluded. RESULTS: From January 1995 to December 2006, 19 of about 8,500 patients had had one or more video-EEGs with FOS, yielding an approximate incidence of 0.2%. From the 14 patients with full clinical and EEG data available, 12 had various epilepsies that included IGE phenotypes (7), symptomatic or probably symptomatic focal (3), cryptogenic generalised (1), and adult onset idiopathic photosensitive occipital (1), and two had no seizures. Seven patients (50%) were photosensitive. FOS EEG abnormalities were occipital in six patients, generalised in eight, and generalised with posterior emphasis in two patients. Seven of these patterns were associated with habitual seizures in seven patients, but actual FOS-induced seizures (absences) were documented with video EEG in only one patient; three others had some historical evidence suggesting that, under some circumstances, their FOS EEG abnormalities might generate clinical seizures. CONCLUSIONS: Despite the association of FOS with generalised and focal, symptomatic and cryptogenic and mild or pharmaco-resistant epilepsies, closer analysis of our data, and supportive evidence from functional imaging and physiological observations on alpha rhythm generation, disclose a prominent role of the occipital areas, even when FOS EEG abnormalities and seizures are ostensibly generalised. Although FOS appears to be of relatively low epileptogenicity, an electroclinical profile of pure FOS epilepsy may exist [Published with video sequences].
Michail Koutroumanidis; Katerina Tsatsou; Sue Sanders; Michael Michael; Stella V Tan; Alexandros Agathonikou; Chrysostomos P Panayiotopoulos
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-03
Journal Detail:
Title:  Epileptic disorders : international epilepsy journal with videotape     Volume:  11     ISSN:  1294-9361     ISO Abbreviation:  Epileptic Disord     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-04-07     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891853     Medline TA:  Epileptic Disord     Country:  France    
Other Details:
Languages:  eng     Pagination:  20-36     Citation Subset:  IM    
Department of Clinical Neurophysiology and Epilepsies, Guy's & St. Thomas' NHS Foundation Trust, London, UK.
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MeSH Terms
Alpha Rhythm*
Brain / pathology,  physiopathology
Epilepsy / complications,  diagnosis,  etiology*,  physiopathology
Fixation, Ocular*
Follow-Up Studies
Magnetic Resonance Imaging
Middle Aged
Occipital Lobe / pathology*,  physiopathology*
Young Adult

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