Electrographic Features of Epilepsy With Eyelid Myoclonia With Photoparoxysmal Responses.

Ifrah Zawar, Bijina Shreshtha, D. Benech, R. Burgess, Juan Bulacio, E. P. Knight
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引用次数: 2

Abstract

PURPOSE Epilepsy with eyelid myoclonia (EMA) is characterized by eyelid myoclonia, eyelid closure sensitivity, and photosensitivity. EEG may manifest with frontal-predominant (FPEDs) or occipital-predominant epileptiform discharges (OPEDs). Data on clinical and electrographic features of these two subtypes are lacking. The purpose of our research was to look at baseline electroclinical features of EMA subtypes and to study electrographic findings of patients with EMA during intermittent photic stimulation (IPS). METHODS We retrospectively identified all patients who had photoparoxysmal responses on EEGs performed at Cleveland clinic between January 01, 2012, and December 31, 2019. Patients who met diagnostic criteria for EMA were studied further. RESULTS Of the 249 patients with photoparoxysmal responses, 70 (28.1%) had EMA (62 [88.6%] female; the mean age of epilepsy onset: 7.0 ± 7.9 years). Patients with EMA had either FPEDs or OPEDs. Eleven patients with EMA (15.7%) had seizures (4 absence, 5 myoclonic and 2 bilateral tonic-clonic) during IPS. Patients with OPEDs were more likely to have drug-resistant epilepsy; occipital focal IEDs and other focal IEDs (other than frontal/occipital) on baseline EEG; and generalized IEDs with occipital predominance, generalized IEDs with no predominance, or focal IEDs during IPS. Predictors of seizure occurrence during photic stimulation included the presence of focal occipital IEDs on baseline EEG, generalized IEDs with frontal predominance during IPS, and photoparoxysmal response outlasting the stimulus. CONCLUSIONS Our study provides evidence that EMA has two distinct subtypes, which differ in clinical characteristics, baseline EEG, and EEG during photic stimulation. We highlight diagnostic and prognostic implications of these findings. Our study also details EEG characteristics of patients with EMA during IPS.
伴有光阵反应的眼睑肌阵挛性癫痫的电图特征。
目的癫痫合并眼睑肌阵挛(EMA)以眼睑肌阵挛、眼睑闭合敏感和光敏为特征。脑电图可表现为额部占优势(FPEDs)或枕部占优势的癫痫样放电(OPEDs)。缺乏这两种亚型的临床和电图特征资料。我们研究的目的是观察EMA亚型的基线电临床特征,并研究间歇性光刺激(IPS)时EMA患者的电图表现。方法回顾性分析2012年1月1日至2019年12月31日在克利夫兰诊所进行脑电图检查的所有有光阵发性反应的患者。对符合EMA诊断标准的患者进行进一步研究。结果249例有光性发作反应的患者中,有EMA的70例(28.1%),其中女性62例(88.6%);癫痫发作平均年龄:7.0±7.9岁。EMA患者有FPEDs或oped。11例EMA患者(15.7%)在IPS期间发生癫痫发作(4例无发作,5例肌阵挛,2例双侧强直-阵挛)。oped患者更容易发生耐药癫痫;枕部局灶性ied和其他局灶性ied(不包括额部/枕部)基线脑电图;以及枕部占优势的广泛性ied、无优势的广泛性ied或IPS期间的局灶性ied。光刺激期间癫痫发作的预测因素包括基线脑电图上出现局灶性枕部ied, IPS期间出现以额部为主的广泛性ied,以及光性发作反应持续时间超过刺激。结论EMA有两种不同的亚型,其临床特征、基线脑电图和光刺激时的脑电图不同。我们强调这些发现的诊断和预后意义。我们的研究还详细介绍了EMA患者在IPS期间的脑电图特征。
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