Cases reported "Epilepsy, Rolandic"

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1/14. Redundancy gains for visual search after complete commissurotomy.

    Redundant-targets effects (RTE) for visual search were investigated in 2 commissurotomy patients (L.B., N.G.). L.B., who showed no evidence of visual interhemispheric transfer, exhibited a paradoxical enhancement of the redundancy gain in the bilateral compared with the within-hemifield redundant-targets conditions, whereas N.G., who showed evidence of interhemispheric transfer of visual information, exhibited no enhancement of the bilateral redundancy gain. When only uncrossed responses were considered, both bilateral and within-field RTE were evident only when attentional demands were high. Bilateral redundant targets led to stronger gains, some indicative of coactivation, in the slower response hand. The authors suggest that the enhancement of the bilateral RTE comes about by neural coactivation, which is especially pronounced when the slower hemisphere elicits the response.
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ranking = 1
keywords = visual
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2/14. epilepsy and perisylvian lipoma/cortical dysplasia complex.

    Intracranial lipomas are congenital malformations composed of mature adipocytes. They are usually located in the midline, particularly in the pericallosal region, a hemispheric location accounting for only 3 to 7% of cases. review of the literature found 21 previous cases of hemispheric lipoma. Although hemispheric cerebral lipomas are rare, association with epilepsy appears to be frequent. We have recently studied two patients in whom epilepsy was the first clinical manifestation of hemispheric cerebral lipoma in the sylvian region. The patients presented with simple motor partial seizures as the first manifestation of the lesion. Neurological examination was normal. MRI disclosed in both cases a lesion involving the sylvian fissure with characteristics of the lipid signal. MRI also demonstrated abnormalities involving the cerebral cortex in the vicinity of the lesion (pachygyria-like aspect). Partial excision of the lesion was achieved in one patient but was followed by a worsening of seizures and neurological condition (hemiparesis). According to the literature, the prognosis for epilepsy in patients with hemispheric lipoma appears good. Several other arguments support non-surgical management: the lesion is benign and can be identified with a high degree of certainty by imaging; surgery is technically difficult due to adherence to adjacent vascular and cerebral structures and hypervascularity; location near functional brain tissue increases the risk of postoperative sequelae. In addition, mechanisms of epilepsy probably involve vascular and cortical dysplasic abnormalities. In consideration of the complexity of the lesion, hemispheric lipomas are more appropriately classified with localized cortical malformations rather than as simple extracerebral malformations.
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ranking = 12.758917949846
keywords = cortex
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3/14. Can protrusion of the tongue stop seizures in Rolandic epilepsy?

    We report the case of a child with benign partial epilepsy with centro-temporal spikes (BECT) in whom protrusion of the tongue stopped the interictal abnormalities, and describe the polygraphic EEG recording of a seizure which terminated upon voluntary protrusion of the tongue. We mention the close link between the post-central (somatosensory) cortex and pre-central (motor) cortex, and how the primary sensory area has direct access to the motor cortex. We also examine how a tactile stimulus may provoke the inhibition of an epileptic discharge.
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ranking = 38.276753849537
keywords = cortex
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4/14. Familial paroxysmal exercise-induced dyskinesia and benign epilepsy: a clinical and neurophysiological study of an uncommon disorder.

    We report a family with 6 members affected by a long-lasting paroxysmal exertion-induced dyskinesia. fasting and stress were precipitating factors. All the patients of this family had also epileptic seizures mainly of generalised type with a favourable outcome. All patients were submitted to a neurophysiological study which included somatosensory evoked potentials by median nerve stimulation (MN-SEPs), somatosensory evoked potentials by posterior tibial nerve stimulation (PTN-SEPs), brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs), motor evoked potentials (MEPs) by magnetic transcranial cortical stimulation (TCS) and electromyography (EMG). The neurophysiological findings suggest a hyperexcitability at the muscular and brain membrane levels, probably due to an ion channel disorder.
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ranking = 0.14285714285714
keywords = visual
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5/14. Rolandic discharges in benign childhood epilepsy with centrotemporal spikes, and in other forms of partial epilepsies.

    Previous reports concerning benign childhood epilepsy with centrotemporal spikes (BECT) were re-investigated, including new data concerning both the presentation of the long-term clinical courses of three cases and the results of magnetoencephalography (MEG) in one patient, with respect to the following points; (1) the electro-clinical characteristics of sylvian seizures and rolandic discharges (RD), and (2) long-term outcome of idiopathic and symptomatic partial epilepsies with RD other than BECT. The epileptic focus of sylvian seizures is located either in the inferior rolandic cortex or underneath the sylvian fissure, which is strongly supported by the results of clinical seizure manifestations, ictal and interictal EEG findings, and interictal MEG findings. The presence of rolandic discharges is not a hallmark of benign outcome. Instead, the presence of sylvian seizures heralds a benign outcome of partial epilepsy regardless of the presence or absence of an organic lesion. The pathophysiological mechanism of BECT remains unknown. Further neurophysiological as well as genetic investigations are needed.
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ranking = 12.758917949846
keywords = cortex
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6/14. Fixation-off sensitivity in an adult with symptomatic occipital epilepsy.

    An adult patient had EEG occipital spike fixation-off sensitivity and spontaneous occipital seizures due to perinatal asphyxia with bioccipital hemorrhage. EEG abnormalities consisted of repetitive posterior spikes that occurred when the eyes were closed and other conditions of fixation-off. magnetic resonance imaging (MRI) documented severe posterior lesions with wallerian degeneration of the optic radiation. Electron capture detector single-photon emission computed tomography (ECD-SPECT) during the state of fixation-off showed regional hyperperfusion in the right posterior regions. We suggest that partial denervation of the primary visual cortex in this patient resulted in an increased cortical excitability and that the inhibitory effect of central vision and fixation leads to a suppression of spontaneous epileptic activity. This unusual symptomatic case may serve as a model for the pathophysiology in the more often reported cases of idiopathic benign epilepsy syndrome of childhood.
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ranking = 12.901775092703
keywords = cortex, visual
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7/14. Malignant rolandic-sylvian epilepsy in children: diagnosis, treatment, and outcomes.

    OBJECTIVE: To describe the diagnosis, treatment, and outcomes in children with malignant rolandic-sylvian epilepsy (MRSE), defined as a form of epilepsy characterized by sensorimotor seizures, medical refractoriness, normal MRI, frontocentrotemporal EEG spikes, rolandic-sylvian spike sources on magnetoencephalography (MEG), and cognitive problems. methods: A retrospective chart analysis of seven patients who had shown these characteristics and undergone extensive diagnostic testing, including MEG and intracranial video-EEG was performed. RESULTS: Interictal scalp EEG spikes were seen over the frontocentrotemporal regions bilaterally (6) and unilaterally (1). MEG showed spike sources in the perisylvian region in two patients (both bilateral) and in the perirolandic fissure in five (two bilateral). Three patients required bilateral subdural strips to lateralize seizures before electrocorticography. Final electrocorticograms showed an ictal onset zone around the rolandic (four cases) and rolandic-sylvian regions (three cases). Six patients showed neuropsychological deficits. After cortical excision and multiple subpial transection, three were seizure free and four had seizures rarely (30 months' mean follow-up). No child had a permanent deficit in sensorimotor or cognitive functions, although two showed exacerbation of preexisting attentional deficits. Tissue analysis showed definite evidence of neuronal migration disorders (3) and gliosis (2). CONCLUSIONS: MEG was helpful for localizing both malignant rolandic-sylvian neuronal activities and functional cortex. Successive neuropsychological assessments are necessary to detect cognitive deterioration and indicate remedial programming. If, after careful observation over at least 5 years, surgery is considered to control refractory seizures, intracranial video-EEG is needed to localize the epileptogenic zone.
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ranking = 12.758917949846
keywords = cortex
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8/14. The existence of two sources in rolandic epilepsy: confirmation with high resolution EEG, MEG and fMRI.

    In benign rolandic epilepsy seizure semiology suggests that the epileptic focus resides in the lower sensorimotor cortex. Previous studies involving dipole modeling based on 32 channel EEG have confirmed this localization. These studies have also suggested that two distinct dipole sources are required to adequately describe the typical interictal spikes. Since in benign epilepsy invasive validation is prohibited, this study tries to further establish these results using a multi-modal approach, involving 32 channel EEG, high resolution 84 channel EEG, 151 channel MEG and fMRI. From one patient interictal spikes were recorded and analyzed using the music algorithm in a realistic volume conductor model. In an fMRI experiment the same patient performed voluntary tongue movements, thus mimicking a typical seizure. Results show that EEC, MEG and fMRI localization converge on the same area in the lower part of the sensorimotor cortex, and that high resolution EEG clearly reveals two distinct sources, one in the post- and one in the pre-central cortex.
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ranking = 38.276753849537
keywords = cortex
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9/14. Seizure's outcome after cortical resections including the face and tongue rolandic areas in patients with refractory epilepsy and normal MRI submitted to subdural grids' implantation.

    PURPOSE: To study the seizure's outcome in patients with refractory epilepsy and normal MRI submitted to resections including the rolandic cortex. methods: Four adult patients were studied. All patients had motor or somatosensory simple partial seizures and normal MRI and were submitted to subdural grids' implantation with extensive coverage of the cortical convexity (1 in the non-dominant and 3 in the dominant hemisphere). RESULTS: ECoG was able to define focal areas of seizures' onset in every patient. All patients were submitted to resection of the face and tongue motor and sensitive cortex; two patients had resections including the perirolandic cortex and 2 had additional cortical removals. Three patients are seizures' free and one had a greater then 90% reduction in seizure frequency. CONCLUSION: Resections including the face and tongue rolandic cortex can be safely performed even within the dominant hemisphere.
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ranking = 51.035671799382
keywords = cortex
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10/14. Ictal electroencephalography in a case of benign centrotemporal epilepsy.

    The purpose of this research was to publish a complete ictal electroencephalographic (EEG) record of a child with benign centrotemporal epilepsy. The record includes a brief description of the patient's epilepsy syndrome, analysis of interictal and ictal EEG records, and a description of corresponding clinical ictal events. Ictal EEG activity appeared over the right rolandic cortex and spread to adjacent sites. Initial rhythmic activity was followed by bilateral series of sharply contoured slow waves. The electric field of the seizure discharge changed during the seizure. Tangentially oriented dipolar field was found in the middle part of the seizure. Evolution of clinical seizure phenomena roughly corresponded to propagation of the ictal discharge. In terms of topography and electromorphology, this ictal record was similar but not completely identical with those reported previously. Collection of further ictal records in benign rolandic or centrotemporal epilepsy of childhood and other epilepsy syndromes is necessary.
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ranking = 12.758917949846
keywords = cortex
(Clic here for more details about this article)
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