Seizure clustering during epilepsy monitoring

被引:95
作者
Haut, SR
Swick, C
Freeman, K
Spencer, S
机构
[1] Montefiore Med Ctr, Dept Neurol, Bronx, NY 10467 USA
[2] Montefiore Med Ctr, Comprehens Epilepsy Management Ctr, Bronx, NY 10467 USA
[3] Montefiore Med Ctr, Epidemiol & Social Med, Bronx, NY 10467 USA
[4] Yale Univ, Sch Med, New Haven, CT USA
[5] Albert Einstein Coll Med, New Haven, CT USA
关键词
seizure clustering; seizure localization; epilepsy monitoring; intractable epilepsy; temporal lobe epilepsy;
D O I
10.1046/j.1528-1157.2002.26401.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose: To identify risk factors associated with seizure clustering during epilepsy monitoring and to assess the effect of clustering on localization of the epileptogenic zone. Methods: Patients undergoing presurgical epilepsy monitoring at Montefiore Medical Center or Yale-New Haven Hospital were recruited. Seizure clustering was defined as three or more seizures within 24 h. Risk factors for seizure clustering were examined by using regression analysis. The effect of clustering on localization was examined by Student's t test evaluation of mean interseizure interval for consecutive concordant and discordant seizures. Results: Of 91 patients, clustering was present in 56 (61.5%). Variables significantly associated with clustering included a history of seizure clustering at home (p = 0.0003) and the presence of mesial temporal sclerosis (NITS) on magnetic resonance imaging (MRI; p = 0.0172). Clustering was present in nine of 10 patients with more than one seizure-onset zone. Ictal EEG localization was not associated with clustering, nor was rapid medication withdrawal. Mean interseizure intervals were not significantly different for concordant and discordant seizures. Conclusions: Seizure clustering during epilepsy monitoring is common. Risk factors include history of clustering at home, MTS on MRI, and possibly more than one seizure focus. In this study, seizures that occurred in clusters had as important a role in localization as did nonclustered seizures.
引用
收藏
页码:711 / 715
页数:5
相关论文
共 13 条
[1]   SEIZURE FREQUENCY IN INTRACTABLE PARTIAL EPILEPSY - A STATISTICAL-ANALYSIS [J].
BALISH, M ;
ALBERT, PS ;
THEODORE, WH .
EPILEPSIA, 1991, 32 (05) :642-649
[2]  
Bauer J, 1992, Schweiz Arch Neurol Psychiatr (1985), V143, P117
[3]   TEMPORAL CHARACTERISTICS OF SEIZURES AND EPILEPTIFORM DISCHARGES [J].
BINNIE, CD ;
AARTS, JHP ;
HOUTKOOPER, MA ;
LAXMINARAYAN, R ;
DASILVA, AM ;
MEINARDI, H ;
NAGELKERKE, N ;
OVERWEG, J .
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1984, 58 (06) :498-505
[4]   PREVALENCE OF BILATERAL PARTIAL SEIZURE FOCI AND IMPLICATIONS FOR ELECTROENCEPHALOGRAPHIC TELEMETRY MONITORING AND EPILEPSY SURGERY [J].
BLUM, D .
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1994, 91 (05) :329-336
[5]   The association between seizure clustering and convulsive status epilepticus in patients with intractable complex partial seizures [J].
Haut, SR ;
Shinnar, S ;
Moshé, SL ;
O'Dell, C ;
Legatt, AD .
EPILEPSIA, 1999, 40 (12) :1832-1834
[6]   Seizure lateralization during EEG monitoring in patients with bilateral foci: The cluster effect [J].
Haut, SR ;
Legatt, AD ;
ODell, C ;
Moshe, SL ;
Shinnar, S .
EPILEPSIA, 1997, 38 (08) :937-940
[7]   Intracranial EEG seizure-onset patterns in neocortical epilepsy [J].
Lee, SA ;
Spencer, DD ;
Spencer, SS .
EPILEPSIA, 2000, 41 (03) :297-307
[8]   An analysis of clinical seizure patterns and their localizing value in frontal and temporal lobe epilepsies [J].
Manford, M ;
Fish, DR ;
Shorvon, SD .
BRAIN, 1996, 119 :17-40
[9]   TIMING OF SEIZURE RECURRENCE IN ADULT EPILEPTIC PATIENTS - A STATISTICAL-ANALYSIS [J].
MILTON, JG ;
GOTMAN, J ;
REMILLARD, GM ;
ANDERMANN, F .
EPILEPSIA, 1987, 28 (05) :471-478
[10]  
MITCHELL WG, 1996, EPILEPSIA S, V37, P74