Panayiotopoulos syndrome: video-EEG illustration of a typical seizure

Panayiotopoulos syndrome (PS) is a form of idiopathic, partial epilepsy of childhood with a high prevalence rate, but with poor clinical recognition, possibly due to the characteristics of the seizure, which not infrequently lack common epileptic motor and/or sensory phenomena. Instead, autonomic symptoms such as retching and vomiting, predominate. Semiological knowledge of the seizures in PS depends mainly on parental observations, but not enough ictal-EEG data are available, possibly due to the rarity of seizures. In addition to previous knowledge regarding the occipital onset of seizures in PS, it has been recognized that other areas, mainly the frontal regions, may be involved. The present report demonstrates the video-EEG findings of a seizure in a patient with PS. Subclinical ictal EEG discharges with occipital onset precede the clinical autonomic symptoms; eye deviation which is typical of occipital involvement, appears in later sequences. These findings suggest that at least for certain seizures an occipital origin may be considered, even in seizures without the early manifestations typical of this region. (Published with videosequences)

Informative value of magnetic resonance imaging and EEG in the prognosis of infantile spasms

Purpose: To investigate the informative value of EEG and cranial magnetic resonance imaging (cMRI) in the prognosis of infantile spasms (ISs); 86 patients with ISs were included in this study

Magnetic resonance imaging findings in infantile spasms: Etiologic and pathophysiologic aspects

An etiologic evaluation of 86 patients with infantile spasms is presented and the place of cranial magnetic resonance imaging (MRI) findings within this spectrum. is discussed. A total of 103 cranial MRIs, performed between 4 and 72 months of age, were analyzed and classified according to the etiologic and pathophysiologic aspects. Ninety-one percent of cases were diagnosed as symptomatic infantile spasms, and hypoxic-ischemic encephalopathy was the primary cause (30%). The most common involvement was thinning of the corpus callosum in 43 patients (50%), followed by dilation of cerebral ventricles in 32 (36%), delayed myelination in 23 (26.7%), lesions of diencephalic deep gray matter in 17 (19.7%), and enlargement of the subarachnoid space in 12 (14%). Thin corpus callosum and diffuse atrophy were changes mainly associated with hypoxic-ischemic encephalopathy, whereas delayed myelination seemed to be independent from a specific etiology. The results showed that cranial MRI may provide considerable information regarding not only the etiology but also the pathophysiology of infantile spasms. (J Child Neurol 2003; 18:241-246)

Enhancement of spike and wave discharges by microinjection of bicuculline into the reticular nucleus of rats with absence epilepsy

The aim of this study was to demonstrate the effect of administration of gamma-aminobutyric acid (GABA)(A) receptor antagonist, bicuculline, into the reticular nucleus of the thalamus (nRt) on spike and wave discharges (SWD) and cardiovascular regulation in conscious rats with genetic absence epilepsy. Rats were instrumented with guide cannulas for drug injection and extradural electrodes for electroencephalogram recording. After a 1 week recovery period, iliac arterial catheters were inserted for direct measurement of blood pressure and heart rate. Administration of bicuculline into the nRt produced increases in spontaneous SWD and failed to alter blood pressure and heart rate. These data suggest that GABA(A) receptors located within the nRt are involved in the incidence of SWD, whereas they do not seem to be involved in cardiovascular regulation of rats with genetic absence epilepsy. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

A study on visual evoked responses in childhood epilepsy with occipital paroxysms

As some apparently idiopatic epilepsies may occasionally pose diagnostic difficulties in regard to their precise status of etiology, evoked potentials, particularly visual evoked potential (VEP), may contribute to the diagnosis of childhood epilepsy with occipital paroxysms (CEOP) as a subsidiary method of evaluation

A retrospective analysis of patients with febrile seizures followed by epilepsy

This study was performed to investigate some clinical parameters of febrile seizures (FSs) in patients with epilepsy, testing any possible correlation between those parameters and the type of subsequent epilepsy. One hundred and nine patients with epilepsy having a history of FSs were evaluated for age at onset of FSs, interval between first FS and first afebrile seizure, recurrence rate, type of FSs, incidence of febrile status, family history for epilepsy and for FSs and the neurological status of the patient. The epilepsy that developed subsequently, were classified as generalised versus partial and also according to their syndromic subgroups. In temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS), statistical analyses revealed a younger age at onset of FSs, and a high incidence of episodes of febrile status and of complex FSs. Clinical characteristics of FSs followed by partial epilepsies were younger age at onset, presence of focal features and of febrile status, longer interval between the first FS and the first afebrile seizure, and a high incidence of FSs in the family history. In generalised epilepsies, however, a shorter interval between the first FS and the first afebrile seizure, a high incidence of single FS and of a family history of epilepsy were predominating characteristics. Results suggest that certain features of FSs may be predictive of a particular type of subsequent epilepsy. (C) 2002 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved

A study on visual evoked responses in children with chronic renal failure

Aims of the study. - Nervous involvement is frequent in patients with renal failure. Early recognition of the condition by electrophysiological tests may provide means for protective measures before irreversible damage of nervous system (NS) structures takes place. This study has two objectives: (1) examining whether pattern-reversal visual evoked potential (PR-VEP) studies may provide information relating to possible subclinical NS involvement in pediatric patients with chronic renal failure (CRF) and (2) looking for a possible relationship between serum parathormone (PTH) and creatinine levels and PR-VEP parameters