Early thalamic lesions in patients with sleep-potentiated epileptiform activity.

Abstract

OBJECTIVE:

To compare the prevalence and type of early developmental lesions in patients with a clinical presentation consistent with electrical status epilepticus in sleep either with or without prominent sleep-potentiated epileptiform activity (PSPEA).

METHODS:

We performed a case-control study and enrolled patients with 1) clinical features consistent with electrical status epilepticus in sleep, 2) ≥1 brain MRI scan, and 3) ≥1 overnight EEG recording. We quantified epileptiform activity using spike percentage, the percentage of 1-second bins in the EEG tracing containing at least 1 spike. PSPEA was present when spike percentage during non-REM sleep was ≥50% than spike percentage during wakefulness.

RESULTS:

One hundred patients with PSPEA (cases) and 47 patients without PSPEA (controls) met the inclusion criteria during a 14-year period. Both groups were comparable in terms of clinical and epidemiologic features. Early developmental lesions were more frequent in cases (48% vs 19.2%, p = 0.002). Thalamic lesions were more frequent in cases (14% vs 2.1%, p = 0.037). The main types of early developmental lesions found in cases were vascular lesions (14%), periventricular leukomalacia (9%), and malformation of cortical development (5%). Vascular lesions were the only type of early developmental lesions that were more frequent in cases (14% vs 0%, p = 0.005).

CONCLUSIONS:

Patients with PSPEA have a higher frequency of early developmental lesions and thalamic lesions than a comparable population of patients without PSPEA. Vascular lesions were the type of early developmental lesions most related to PSPEA.

• Authors: I Sánchez Fernández, M Takeoka, E Tas, J M Peters, S P Prabhu, K M Stannard, M Gregas, Y Eksioglu, A Rotenberg, J J Riviello Jr, S V Kothare, T Loddenkemper
• Journal: Neurology (Neurology) Vol. 78 Issue 22 Pg. 1721-7 (May 29 2012) ISSN: 1526-632X [Electronic] United States
• PMID: 22539569 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Case-Control Studies
• Cerebral Cortex (abnormalities, physiopathology)
• Child
• Child, Preschool
• Electroencephalography
• Female
• Humans
• Infant
• Infant, Newborn
• Leukomalacia, Periventricular (complications, physiopathology)
• Magnetic Resonance Imaging
• Male
• Medical History Taking
• Polysomnography
• Premature Birth
• Sleep
• Status Epilepticus (diagnosis, etiology, pathology, physiopathology)
• Stroke (complications, physiopathology)
• Thalamus (pathology, physiopathology)
• Young Adult