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Query: UMLS:C0149958 (complex partial seizures)
 2,563 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review emphasizes clinical manifestations, recognition of specific epileptic syndromes, use of antiepileptic drugs, and surgical evaluation and outcome. Juvenile myoclonic epilepsy is increasingly recognized but still underdiagnosed. Good evidence exists for a relationship between Landau-Kleffner syndrome (acquired epileptic aphasia) and electrical status epilepticus during sleep, which reflects the course of the aphasia. In focal onset seizures, the type of aura may be as valuable for determining the lobe of seizure onset as electroencephalographic and neuroimaging techniques. In temporal lobe seizures, postictal language assessment was used to determine the side of origin, and hippocampal and temporal volumetry using magnetic resonance imaging proved reliable indicators of the side of involvement. Valproate sodium and carbamazepine were equally effective for secondarily generalized tonic-clonic seizures, but carbamazepine was superior to valproate for complex partial seizures. One study suggests that in children, increased daytime sleep tendency persists 4 to 5 months after discontinuation of antiepileptic drugs and that neither drugs nor seizure activity are necessarily involved. Many recent publications were devoted to surgical treatment. The main issues reviewed concern patient selection and correlation between preoperative parameters and outcome after surgery.
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PMID:Clinical aspects of epilepsy including diagnosis, management, pharmacotherapy, and surgery. 848 66

This study analyzes the relative frequency and age of onset of the different seizure types in a 20-year cohort of a pediatric neurology outpatient clinic of an urban hospital that serves the majority of the city's population (Tel Aviv Medical Center). Only patients with two or more unprovoked seizures were included. Neonatal seizures were excluded from the analysis. The different seizure types in descending order of frequency were: partial seizures secondarily generalized (20.6%), complex partial seizures (12.5%), West syndrome (9%), simple partial seizures (8.6%), benign rolandic epilepsy of childhood (8%), absence seizures (7%), generalized tonic-clonic seizures (6.6%), generalized tonic seizures (5%), myoclonic seizures (2.2%), benign occipital epilepsy of childhood (2%), mixed type seizures (1.8%), Lennox-Gastaut syndrome (1.5%), juvenile myoclonic epilepsy (0.9%), atypical absence (0.6%), Landau-Kleffner syndrome, Ohtahara syndrome, myoclonic astatic epilepsy, electrical status epilepticus in sleep and startle epilepsy (0.2% each), and unclassified seizures (12%). The findings of this study confirm that there are more pediatric patients with partial seizures (52%) than primary generalized seizures (33%) and that partial seizures secondarily generalized is the most frequent seizure type in this age group.
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PMID:Epidemiology of epilepsy in childhood: a cohort of 440 consecutive patients. 949 91

We describe the case of a man with a history of complex partial seizures and severe language, cognitive and behavioural regression during early childhood (3.5 years), who underwent epilepsy surgery at the age of 25 years. His early epilepsy had clinical and electroencephalogram features of the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia (Landau-Kleffner syndrome), which we considered initially to be of idiopathic origin. Seizures recurred at 19 years and presurgical investigations at 25 years showed a lateral frontal epileptic focus with spread to Broca's area and the frontal orbital regions. Histopathology revealed a focal cortical dysplasia, not visible on magnetic resonance imaging. The prolonged but reversible early regression and the residual neuropsychological disorders during adulthood were probably the result of an active left frontal epilepsy, which interfered with language and behaviour during development. Our findings raise the question of the role of focal cortical dysplasia as an aetiology in the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia.
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PMID:Childhood epilepsy with neuropsychological regression and continuous spike waves during sleep: epilepsy surgery in a young adult. 1072 97

A 39-year-old man, who presented at age 312 with Landau-Kleffner syndrome, had persisting oral and written language deficits into adulthood. Seizures were easily controlled in childhood, but reemerged in adulthood as medication-refractory complex partial seizures. Abnormal T2 signal hyperintensity was seen in the left mesial temporal area on brain MRI. Later, left temporal lobectomy revealed focal cortical dysplasia in the lateral temporal neocortex and gliosis plus neuronal loss in the hippocampus. This case suggests that focal cortical microdysgenesis may be a cause of the Landau-Kleffner syndrome. Persistent seizures in this illustrative case may have led to the evolution of dual-temporal-lobe pathology with mesial temporal sclerosis.
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PMID:Landau-Kleffner syndrome with lateral temporal focal cortical dysplasia and mesial temporal sclerosis: a 30-year follow-up. 1734 54