The clinical presentation and diagnosis of epileptic autonomic auras
Abstract
Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA) and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women) aged 9 to 27years (mean 18±5years) were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI) of the brain. Results. In most patients (n = 12, 67%), the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG) were present in the frontal, temporal, and frontotemporal regions in 4 (22%), 6 (33%), and 7 (39%) patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72%) patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.
References
1. <div><p>Броун Т., Холмс Г. Эпилепсия. Клиническое руководство. М.: Бином, 2006;288 с.</p><p>Карлов В.А. Эпилепсия у детей и взрослых, женщин и мужчин. Рук-во для врачей. М.: Медицина, 2010; 718 с.</p><p>Luders H.-O., Noachtar S. Epileptic seizures. Pathophysiology and clinical semiology. N.Y.: Churchill Livingstone, 2000;796.</p><p>Luders H.-O., Noachtar S. Atlas of epileptic seizures and syndromes. Philadelphia: W.B. Saunders Company, 2001;204.</p><p>Мухин К.Ю., Петрухин А.С., Глухова Л.Ю. Эпилепсия. Атлас электроклинической диагностики. М.: Альварес Паблишинг, 2004;305—13;407—15.</p><p>Эпилепсия и судорожные синдромы у де тей: руководство для врачей. Под ред. П.А. Темина, М.Ю. Никоноровой. 2-е изд. М.: Медицина, 1999;656 С.</p><p>Rona S. Auras: Localizing and lateralizing value. In: Textbook of Epilepsy Surgery H.O. L?ders (ed.). London/New York: Informa Healthcare, 2008;432-42.</p><p>Wieser H.G. The phenomenology of limbic seizures In: The epileptic focus. H.G.Wieser (ed.). London: J.L., 1987;113-6.</p><p>Arzimanoglou A., Guerrini R., Aicardi J. Aicardi’s epilepsy in children. 3rd ed. Lippincott, Philadelphia, 2004;114—75.</p><p>Smaje J.C., Davidson C., Teasdale G.M. Sino-atrial arrest due to temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 1987;50:112-3.</p><p>Gastaut H., Broughton R. Epileptic Seizures: clinical and electrographic features, diagnosis and treatment. Illinois: Springfield, 1972;268 p.</p><p>Fish D.R., Gloor P., Quesney F.L. et al. Clinical reponses to electri—cal brain stimulation of the temporal and frontal lobes in patients with epilepsy. Pathophysiological impli cations. Brain 1993;116:397-414.</p><p>Pool J.L., Ransohoff H. Autonomic effects on stimulating the rostral portion of the cingulate gyrus in man. J Neurophysiol 1949;12:385-92.</p><p>Mazzola L., Isnard J., Mauguiere F. Somatosensory and pain responses to stimulation of the second somatosensory area (SII) in humans. A comparison with Sl and insular responses. Cerebral Cortex 2006;16(7):960-8.</p><p>Munari C., Tassi L., Di Leo M. et al. Video-stereo-electroencephalographic investigation of orbitofrontal cortex. Ictal electroclinical patterns. Advances in Neurol 1995;66:273-95.</p><p>Henkel A., Noachtar S., Pfander M. et al. The localizing value of the abdominal aura and its evolution: a study in focal epilepsies. Neurology 2002;58(2):271-6.</p><p>Loddenkemper T., Foldvary N., Raja S. et al. Ictal urinary urge: further evidence for lateralization to the nondominant hemisphere. Epilepsia 2003;44(1):124-6.</p><p>Kotagal P., Luders H.-O., Williams G. et al. Psychomotor seizures of temporal lobe onset: analysis of symptom clusters and sequences. Epilepsy Res 1995;20(1):49—67.</p><p>Мухин К.Ю., Миронов М.Б., Барлетова Е.И. Эпилептические ауры: клинические характеристики и топическое значение. М., 2011;54 с.</p><p>So N.K. Epileptic auras. In: The Treatment of Epilepsy: Principles and Practice. E. Wyllie (ed.). London: Jea and Febiger, 1993; 228.</p></div><br />
Review
For citations:
Kremenchugskaya M.R., Barletova E.I., Mukhin K.Yu., Glukhova L.Yu. The clinical presentation and diagnosis of epileptic autonomic auras. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(4):48-53. (In Russ.) https://doi.org/10.14412/2074-2711-2012-421
Views: 628
Email this article 