ABSTRACT
We studied 18 patients with generalized tonic-clonic seizures. The signs of idiopathic epilepsy were as following: normal physical and neurological status, seizures of awakenings, peculiarity of circadian rhythms ("owls"), hyper synchronous type of EEG. The EEG and MRI study revealed insignificant epileptiform or structural changes. The authors consider these findings as possible phenocopies of idiopathic epilepsy.
Subject(s)
Epilepsy, Generalized/classification , Epilepsy, Generalized/physiopathology , Epilepsy, Tonic-Clonic/complications , Epilepsy, Tonic-Clonic/physiopathology , Circadian Rhythm , Electroencephalography , Epilepsy, Generalized/diagnosis , Epilepsy, Tonic-Clonic/diagnosis , HumansABSTRACT
Seventy patients with idiopathic epilepsy with generalized tonic-clonic seizures (GTCS) on awakening were analyzed. In 30% of patients, seizures occurred with the same frequency or less often only on falling asleep. Two groups of patients were specified: with isolated GTCS on awakening and with a combination of the latter with myoclonia and absences. Awakening as a factor provoking seizures can be significant not only for night sleep but also for day sleep, mostly in patients with isolated GTCS. This allows to define the syndrome as an epilepsy with GTCS "around sleep". At the same time, there were 6 patients with clinical and EEG features of symptomatic epilepsy. Heterogeneity of the syndrome with GTCS "around sleep" is also related to the mental state of patients and their response to AED: carbamazepine is more effective in patients with isolated GTCS and valproate in those with the combination of GTCS with myoclonia and absences.
Subject(s)
Epilepsy, Tonic-Clonic/etiology , Sleep Initiation and Maintenance Disorders/complications , Sleep/physiology , Adolescent , Diagnosis, Differential , Electroencephalography/methods , Epilepsy, Tonic-Clonic/diagnosis , Epilepsy, Tonic-Clonic/physiopathology , Female , Follow-Up Studies , Frontal Lobe/physiopathology , Humans , Magnetic Resonance Imaging , Male , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathologyABSTRACT
Despite the substantial progress in the field of diagnostics and treatment of epilepsy, many cases of this disease still remain problematic. One third of patients are refractory to treatment.
