Focal epilepsy in adults: clinical lecture
A.S. Kotov
Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky
Self-limited childhood focal epilepsy or devastating infantile epileptic encephalopathy can be found in persons older than 18 years old. Frontal lobe seizures were divided into 6 groups within video-EEG monitoring: focal clonic of the motor area, asymmetric tonic, hyperkinetic (psychomotor, hyper motor, complex partial), opercular, absence, and seizures similar to medial temporal lobe epilepsy. Temporal lobe epilepsy can be divided into two distinct syndromes: medial, or amygdala-hippocampal, associated with the limbic system disorder in the temporal lobe deep parts, and lateral, or neocortical, which is based on the neocortical temporal disorder. Classic symptoms of parietal lobe epilepsy are presented by paresthesia, usually contralateral to the focus of seizures. Patients can describe ictal somatosensory symptoms as sensations of “crawling”, “numbness”, “pins and needles”, and “cramp”. In occipital lobe epilepsy, ictal visual symptoms can be both positive (described as bright flashes, circles, “crawlings”, “birds”, flickering bright spots, etc.) and negative (in the form of “darkness in front of eyes” (amaurosis) or “black spots” (scotomata). In addition, various oculomotor symptoms, as a tonic eye movement during an occipital seizure, can occur.
Keywords: epilepsy, frontal lobe, temporal lobe, parietal lobe, occipital lobe, clinic, diagnosis, treatment.
For citation: Kotov A.S. Focal epilepsy in adults: clinical lecture. RMJ. Medical Review. 2019;4(II):95–99.
References
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23. Adcock J.E., Panayiotopoulos C.P. Occipital lobe seizures and epilepsies. J Clin Neurophysiol. 2012;29(5):397–407. DOI: 10.1097/WNP.0b013e31826c98fe.
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25. Котов А.С. Оперативные вмешательства и обезболивание у больных эпилепсией. Клиническая лекция. РМЖ. 2015;12:710. [Kotov A.S. Surgery and anesthesia in patients with epilepsy. Clinical lecture. RMJ. 2015;12:710 (in Russ.)].
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28. Куташов В.А., Куташова Л.А. Анализ клинического случая пациента с эпилепсией. РМЖ. 2014;16:1210. [Kutashov V.A., Kutashova L.A. Analysis of the clinical case of a patient with epilepsy. RMJ. 2014;16:1210 (in Russ.)].
2. Kellinghaus C., Lüders H.O. Frontal lobe epilepsy. Epileptic Disord. 2004;6(4):223–239.
3. Kellinghaus C., Kotagal P. Lateralizing value of Todd’s palsy in patients with epilepsy. Neurology. 2004;62:289–291.
4. Nobili L., Cossu M., Mai R. et al. Sleep-related hyperkinetic seizures of temporal lobe origin. Neurology. 2004;62(3):482–485.
5. Staack A.M., Bilic S., Wendling A.S. et al. Hyperkinetic seizures in patients with temporal lobe epilepsy: clinical features and outcome after temporal lobe resection. Epilepsia. 2011;52(8):1439–1446. DOI: 10.1111/j.1528-1167.2011.03100.x.
6. Niedermeyer E. Epileptic seizure disorders. In: Niedermeyer E., Lopes da Silva.F., eds. Electroencephalography: basic principles, clinical applications, and related fields. Baltimore: Urban and Schwarzenberg, 2000.
7. Proserpio P., Cossu M., Francione S. et al. Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia. 2011;52(10):1781–1791. DOI: 10.1111/j.1528-1167.2011.03254.x.
8. Smith J.R., Sillay K., Winkler P. et al. Orbitofrontal epilepsy: electroclinical analysis of surgical cases and literature review. Stereotact Funct Neurosurg. 2004;82(1):20–25.
9. Mueller S.G., Laxer K.D., Cashdollar N. et al. Voxel-based optimized morphometry (VBM) of gray and white matter in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis. Epilepsia. 2006;47(5):900–907.
10. Thom M., Sisodiya S.M., Beckett A. et al. Cytoarchitectural abnormalities in hippocampal sclerosis. J Neuropathol Exp Neurol. 2002;61(6):510–519.
11. Patterson K.P., Baram T.Z., Shinnar S. Origins of temporal lobe epilepsy: febrile seizures and febrile status epilepticus. Neurotherapeutics. 2014;11(2):242–250. DOI: 10.1007/s13311-014-0263-4.
12. Ray A., Kotagal P. Temporal lobe epilepsy in children: overview of clinical semiology. Epileptic Disord. 2005;7:299–307.
13. Javidan M. Electroencephalography in mesial temporal lobe epilepsy: a review. Epilepsy Res Treat. 2012;2012:637430. DOI: 10.1155/2012/637430.
14. Engel J Jr. Functional explorations of the human epileptic brain and their therapeutic implications. Electroencephalogr Clin Neurophysiol. 1990;76:296–316.
15. Guedj E., Bonini F., Gavaret M. et al. 18FDG-PET in different subtypes of temporal lobe epilepsy: SEEG validation and predictive value. Epilepsia. 2015;56(3):414–421. DOI: 10.1111/epi.12917.
16. Kumar A., Chugani H.T. The role of radionuclide imaging in epilepsy, Part 1: Sporadic temporal and extratemporal lobe epilepsy. J Nucl Med. 2013;54(10):1775–1781. DOI: 10.2967/jnumed.112.114397.
17. Котов А.С., Руденко А.М. Криптогенные и симптоматические височные эпилепсии у взрослых. Анналы клинической и экспериментальной неврологии. 2009;3(2):9–13. [Kotov A.S., Rudenko A.M. Cryptogenic and symptomatic temporal epilepsies in adults. Annaly klinicheskoj I ehksperimentalnoj nevrologii. 2009;3(2):9–13 (in Russ.)].
18. Wiebe S., Blume W.T., Girvin J.P. et al. A randomized, controlled trial of surgery for temporal lobe epilepsy. N Engl J Med. 2001;345:311–318.
19. Chabardes S., Kahane P., Minotti L. et al. The temporopolar cortex plays a pivotal role in temporal lobe seizures. Brain. 2005;128:1818–1831.
20. Michelucci R., Poza J.J., Sofia V. et al. Autosomal dominant lateral temporal epilepsy: clinicalspectrum, new epitempin mutations, and genetic heterogeneity in seven European families. Epilepsia. 2003;44(10):1289–1297.
21. Ikeda A., Matsumoto R., Ohara S. et al. Asymmetric tonic seizures with bilateral parietal lesions resembling frontal lobe epilepsy. Epileptic Disord. 2001;3(1):17–22.
22. Котов А.С., Рудакова И.Г., Белова Ю.А., Котов С.В. Затылочная эпилепсия у взрослых. Журнал неврологии и психиатрии им. С.С. Корсакова. 2009;109(7):4–8. [Kotov A.S., Rudakova I.G., Belova Yu.A., Kotov S.V. Occipital epilepsy in adults. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2009;109(7):4–8 (in Russ.)].
23. Adcock J.E., Panayiotopoulos C.P. Occipital lobe seizures and epilepsies. J Clin Neurophysiol. 2012;29(5):397–407. DOI: 10.1097/WNP.0b013e31826c98fe.
24. Куташов В.А., Куташова Л.А. Изменение психического статуса у больных эпилепсией. РМЖ. 2014;16:1153. [Kutashov V.A., Kutashova L.A. Changes in mental status in patients with epilepsy. RMJ. 2014;16:1153 (in Russ.)].
25. Котов А.С. Оперативные вмешательства и обезболивание у больных эпилепсией. Клиническая лекция. РМЖ. 2015;12:710. [Kotov A.S. Surgery and anesthesia in patients with epilepsy. Clinical lecture. RMJ. 2015;12:710 (in Russ.)].
26. Бадалян О.Л., Савенков А.А. Идиопатические эпилепсии подросткового возраста. РМЖ. 2014;16:1151. [Badalyan O.L., Savenkov A.A. Idiopathic epilepsy adolescence. RMJ. 2014;16:1151 (in Russ.)].
27. Бельская Г.Н., Пономарева И.В. Методические рекомендации для врачей. Ведение женщин фертильного возраста и беременных, больных эпилепсией. РМЖ. 2015;16:922. [Belskaya G.N., Ponomareva I.V. Methodical recommendations for doctors. Maintaining women of fertile age and pregnant women with epilepsy. RMJ. 2015;16:922 (in Russ.)].
28. Куташов В.А., Куташова Л.А. Анализ клинического случая пациента с эпилепсией. РМЖ. 2014;16:1210. [Kutashov V.A., Kutashova L.A. Analysis of the clinical case of a patient with epilepsy. RMJ. 2014;16:1210 (in Russ.)].
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