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Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy
Author(s) -
Palmini André,
Halasz Peter,
Scheffer Ingrid E.,
Takahashi Yukitoshi,
Jimenez Angeles Perez,
Dubeau François,
Andermann Frederick,
PaglioliNeto Eliseu,
Da Costa Jaderson Costa,
Rosenow Felix,
Fritsch Brita
Publication year - 2005
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2005.52904.x
Subject(s) - reflex , myoclonus , epilepsy , medicine , anesthesia , refractory (planetary science) , neuroimaging , reflex epilepsy , stimulus (psychology) , neuroscience , epilepsy surgery , psychology , physics , astrobiology , psychotherapist
Summary: Purpose: Malformations of cortical development (MCDs) are usually highly epileptogenic, and their hyperexcitability could facilitate the occurrence of reflex seizures. We sought to characterize reflex seizures in patients with MCDs and refractory epilepsy. Methods: Clinical, electrographic, and neuroimaging data were reviewed in eight patients with MCDs who had reflex seizures reproduced during presurgical evaluation. Results: All eight patients had both reflex and spontaneous seizures. In six, however, drop attacks or axial myoclonic seizures occurred only upon specific sensory stimulation. Reflex seizures were induced by more than one type of stimulus in most patients, but anatomofunctional correlations could usually be invoked. Six patients had significant intellectual impairment. Surgical resection controlled seizures in two patients. Conclusions: Reflex seizures in patients with MCDs may be medically refractory and may often manifest as drop attacks or axial myoclonus. Surgical resection of focal lesions can bring reflex seizures under control. Putative mechanisms related to the relatively low frequency of reflex seizures in MCDs are discussed.