Clinical, Neuroradiological and Electroencephalographic

Objective & Hypothesis:Objectives: We aimed to review the clinical, neuroradiological and electroencephalographic (EEG) findings of patients with epilepsy and malformation of cortical development (MCD).

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Key Findings & Data:Patients with epilepsy, MCD, and ≥18 years of age were included and classified according to the Barkovich classification (BC).

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Conclusion & Impact:We concluded that the prevalence of MCD is 1.21%.

🔬Design:Review & Systematic Survey

📍Scope:2027 Verileri

⚙️Variables:Domain Parameters

Abstract

Objectives: We aimed to review the clinical, neuroradiological and electroencephalographic (EEG) findings of patients with epilepsy and malformation of cortical development (MCD). Methods: A retrospective analysis of the medical records of epilepsy outpatients was done. Patients with epilepsy, MCD, and ≥18 years of age were included and classified according to the Barkovich classification (BC). Results: The files of 2027 patients were assessed, and 17 out of 1395 epilepsy patients who were followed-up were found to have MCD. The mean age was 26.5 years. Ten patients were male and 7 were female. The mean time of seizure onset was 13 years. In terms of seizure type, 11 patients had focal, 10 had generalized tonic-clonic, 1 had absence, 1 had tonic-atonic, and 1 had myoclonic. MRI showed 7 patients with cortical dysplasia, 4 with heterotopia, 2 with periventricular nodular heterotopia, 2 with schiezencephaly, 2 with lissencephaly, 1 with agyria, 1 with pachygyria, 1 with macrogyria, 1 with polymicrogyria, and 1 with tuberous sclerosis. EEG revealed focal epileptiform discharges in 5 patients, high-frequency activity in 2, generalized epileptiform discharge in 1, diffuse disorganized background activity in 1, and focal disorganized background activity in 1. EEG was normal in 7 patients. Four of them were on monotherapy and 13 on polytherapy. Conclusion: The MCDs classified in group 1 and 2 according to BC are more frequent. Treatment-resistant or good responsive cases can be seen and seizures can begin at any age. We concluded that the prevalence of MCD is 1.21%. The spectrum of epilepsy seen is extensive and the most common type of MCD is focal cortical dysplasia.

Özet

Amaç: Epilepsi ve kortikal gelişimsel malformasyonu (KGM) olan hastaların klinik, nöroradyolojik ve elektroensefalografik (EEG) bulgularını gözden geçirmektir. Gereç ve Yöntem: Epilepsi polikliniği tıbbi kayıtları geriye dönük olarak incelendi. Epilepsi, KGM ve yaşı ≥18 olan hastalar dahil edildi ve hastalar Barkovich sınıflamasına (BC) göre gruplandırıldı. Bulgular: İki bin yirmi yedi hasta dosyası incelendi. Takibe devam eden ve epilepsi tanısı konan 1395 olgunun 17’sinde KGM saptandı. Hastaların yaş ortalaması 26.5 yıl idi. Hastaların 10’u erkek, yedisi kadındı. Nöbet başlangıç yaşları ortalaması 13 yıl idi. Olguların 11’inde fokal, 10’unda jeneralize tonik klonik (JTKN), birinde absans, birinde tonik-atonik, birinde miyoklonik nöbet saptandı. MRG’de yedi hastada kortikal displazi, dört hastada heterotopi, iki hastada periventriküler noduler heterotopi, iki hastada şizensefali, iki hastada lizensefali, bir hastada Tubero skleroz, bir hastada agiri, bir hastada pakigiri, bir hastada makrogiri, bir hastada polimikrogiri vardı. EEG’leri değerlendirildiğinde beşinde fokal epileptiform deşarj, ikisinde hızlı ritim, bir hastada jeneralize epileptiform deşarj, bir hastada fokal organizasyon bozukluğu, bir hastada yaygın organizasyon bozukluğu, görülmüştür. Yedi hastanın EEG’leri normaldi. Hastaların üçü monoterapi, 14’ü politerapi altında idi. Sonuç: BC’ye göre grup 1 ve 2’ye giren KGM’lere daha sık rastlanmaktadır. Tedaviye dirençli veya iyi cevap veren olgular görülebilir ve nöbetler her yaşta başlayabilir. Prevalans %1.21 bulundu. Görülen epilepsi spektrumu geniştir ve en sık karşılaşılan KGM tipi fokal kortikal displazidir.

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Cite This Article

TUTKAVUL, K., BAYRAM, T., BAYRAM, D., TİRELİ, H., ÇETİNKAYA, Y. (2022). Clinical, Neuroradiological and Electroencephalographic. Epilepsi, Cilt: 25 - Sayı: 2, 81–87. https://ajindex.com/articles/501654

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