Abstract
Purpose: To elucidate the mechanisms of seizure origin in patients with celiac disease and bilateral occipital calcifications (CEBOC). Individuals with CEBOC frequently present with occipital lobe seizures, but additional lesions and additional attack patterns may occur. Methods: We studied two men and one woman who had CEBOC. Villous atrophy was revealed in the two patients who underwent duodenal biopsy. All had a comprehensive presurgical evaluation, including prolonged video-EEG recordings. Two had magnetic resonance imaging (MRI) with volumetric study of mesial temporal structures (MRIV). One patient had undergone stereotactic intracranial depth electrode studies (SEEG}. Results: All patients presented with intractable complex partial seizures. Two had partial simple seizures with visual aura. Neurologic examination was normal: one was of normal intelligence, and two were mildly retarded. Neuroimaging studies showed that each had bilateral occipital calcifications as well as epileptiform abnormalities over temporal lobes. In one, MRI showed an additional right frontal lesion, but SEEG demonstrated right occipital lobe seizure origin with anterior spread; this male patient later underwent a right occipital lobe resection. Another with a history of prolonged febrile convulsions had bilateral hippocampal and amygdalar atrophy demonstrated by MRIV. Conclusions: In one patient, SEEG confirmed that seizures originated in the occipital lobe. The presence of dual pathology was demonstrated in another, raising the possibility of both occipital and temporal seizure onset. The presence of extraoccipital lesions or of mesial temporal atrophy requires SEEG for clarification of seizure onset. In the absence of confounding factors and when laterality can be demonstrated, surgical treatment may be considered.
| Original language | English |
|---|---|
| Pages (from-to) | 300-306 |
| Number of pages | 7 |
| Journal | Epilepsia |
| Volume | 39 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1998 |
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Keywords
- Celiac disease
- Electroencephalography
- Intractable epilepsy
- MRI
- Occipital calcifications
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)
Cite this
Celiac disease, bilateral occipital calcifications and intractable epilepsy : Mechanisms of seizure origin. / Bernasconi, Andrea; Bernasconi, Neda; Andermann, Frederick; Dubeau, François; Guberman, Alan; Gobbi, Giuseppe; Olivier, André.
In: Epilepsia, Vol. 39, No. 3, 1998, p. 300-306.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Celiac disease, bilateral occipital calcifications and intractable epilepsy
T2 - Mechanisms of seizure origin
AU - Bernasconi, Andrea
AU - Bernasconi, Neda
AU - Andermann, Frederick
AU - Dubeau, François
AU - Guberman, Alan
AU - Gobbi, Giuseppe
AU - Olivier, André
PY - 1998
Y1 - 1998
N2 - Purpose: To elucidate the mechanisms of seizure origin in patients with celiac disease and bilateral occipital calcifications (CEBOC). Individuals with CEBOC frequently present with occipital lobe seizures, but additional lesions and additional attack patterns may occur. Methods: We studied two men and one woman who had CEBOC. Villous atrophy was revealed in the two patients who underwent duodenal biopsy. All had a comprehensive presurgical evaluation, including prolonged video-EEG recordings. Two had magnetic resonance imaging (MRI) with volumetric study of mesial temporal structures (MRIV). One patient had undergone stereotactic intracranial depth electrode studies (SEEG}. Results: All patients presented with intractable complex partial seizures. Two had partial simple seizures with visual aura. Neurologic examination was normal: one was of normal intelligence, and two were mildly retarded. Neuroimaging studies showed that each had bilateral occipital calcifications as well as epileptiform abnormalities over temporal lobes. In one, MRI showed an additional right frontal lesion, but SEEG demonstrated right occipital lobe seizure origin with anterior spread; this male patient later underwent a right occipital lobe resection. Another with a history of prolonged febrile convulsions had bilateral hippocampal and amygdalar atrophy demonstrated by MRIV. Conclusions: In one patient, SEEG confirmed that seizures originated in the occipital lobe. The presence of dual pathology was demonstrated in another, raising the possibility of both occipital and temporal seizure onset. The presence of extraoccipital lesions or of mesial temporal atrophy requires SEEG for clarification of seizure onset. In the absence of confounding factors and when laterality can be demonstrated, surgical treatment may be considered.
AB - Purpose: To elucidate the mechanisms of seizure origin in patients with celiac disease and bilateral occipital calcifications (CEBOC). Individuals with CEBOC frequently present with occipital lobe seizures, but additional lesions and additional attack patterns may occur. Methods: We studied two men and one woman who had CEBOC. Villous atrophy was revealed in the two patients who underwent duodenal biopsy. All had a comprehensive presurgical evaluation, including prolonged video-EEG recordings. Two had magnetic resonance imaging (MRI) with volumetric study of mesial temporal structures (MRIV). One patient had undergone stereotactic intracranial depth electrode studies (SEEG}. Results: All patients presented with intractable complex partial seizures. Two had partial simple seizures with visual aura. Neurologic examination was normal: one was of normal intelligence, and two were mildly retarded. Neuroimaging studies showed that each had bilateral occipital calcifications as well as epileptiform abnormalities over temporal lobes. In one, MRI showed an additional right frontal lesion, but SEEG demonstrated right occipital lobe seizure origin with anterior spread; this male patient later underwent a right occipital lobe resection. Another with a history of prolonged febrile convulsions had bilateral hippocampal and amygdalar atrophy demonstrated by MRIV. Conclusions: In one patient, SEEG confirmed that seizures originated in the occipital lobe. The presence of dual pathology was demonstrated in another, raising the possibility of both occipital and temporal seizure onset. The presence of extraoccipital lesions or of mesial temporal atrophy requires SEEG for clarification of seizure onset. In the absence of confounding factors and when laterality can be demonstrated, surgical treatment may be considered.
KW - Celiac disease
KW - Electroencephalography
KW - Intractable epilepsy
KW - MRI
KW - Occipital calcifications
UR - http://www.scopus.com/inward/record.url?scp=0031912855&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031912855&partnerID=8YFLogxK
U2 - 10.1111/j.1528-1157.1998.tb01377.x
DO - 10.1111/j.1528-1157.1998.tb01377.x
M3 - Article
C2 - 9578049
AN - SCOPUS:0031912855
VL - 39
SP - 300
EP - 306
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 3
ER -