Abstract
Purpose: To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation. Methods: In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded. Key Findings: Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies. Significance: The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
| Original language | English |
|---|---|
| Pages (from-to) | 1168-1176 |
| Number of pages | 9 |
| Journal | Epilepsia |
| Volume | 52 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2011 |
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Keywords
- Aura continua
- Developments of epilepsia partialis continua
- Epilepsia partialis continua etiologies
- Focal status epilepticus
- Nonprogressive epilepsia partialis continua
- Sensory epilepsia partialis continua
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua : A European survey and analysis of 65 cases. / Mameniskiene, Ruta; Bast, Thomas; Bentes, Carla; Canevini, Maria P.; Dimova, Petia; Granata, Tiziana; Høgenhaven, Hans; Jakubi, Bosanka Jocic; Marusic, Petr; Melikyan, Gayane; Michelucci, Roberto; Mukhin, Konstantin Y.; Oehl, Bernhard; Ragona, Francesca; Rossetti, Andrea O.; Rubboli, Guido; Schubert, Susanne; Stephani, Ulrich; Strobel, Julia; Vignoli, Aglaia; Zarubova, Jana; Wolf, Peter.
In: Epilepsia, Vol. 52, No. 6, 06.2011, p. 1168-1176.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua
T2 - A European survey and analysis of 65 cases
AU - Mameniskiene, Ruta
AU - Bast, Thomas
AU - Bentes, Carla
AU - Canevini, Maria P.
AU - Dimova, Petia
AU - Granata, Tiziana
AU - Høgenhaven, Hans
AU - Jakubi, Bosanka Jocic
AU - Marusic, Petr
AU - Melikyan, Gayane
AU - Michelucci, Roberto
AU - Mukhin, Konstantin Y.
AU - Oehl, Bernhard
AU - Ragona, Francesca
AU - Rossetti, Andrea O.
AU - Rubboli, Guido
AU - Schubert, Susanne
AU - Stephani, Ulrich
AU - Strobel, Julia
AU - Vignoli, Aglaia
AU - Zarubova, Jana
AU - Wolf, Peter
PY - 2011/6
Y1 - 2011/6
N2 - Purpose: To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation. Methods: In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded. Key Findings: Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies. Significance: The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
AB - Purpose: To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation. Methods: In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded. Key Findings: Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies. Significance: The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
KW - Aura continua
KW - Developments of epilepsia partialis continua
KW - Epilepsia partialis continua etiologies
KW - Focal status epilepticus
KW - Nonprogressive epilepsia partialis continua
KW - Sensory epilepsia partialis continua
UR - http://www.scopus.com/inward/record.url?scp=79958861318&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79958861318&partnerID=8YFLogxK
U2 - 10.1111/j.1528-1167.2010.02974.x
DO - 10.1111/j.1528-1167.2010.02974.x
M3 - Article
C2 - 21320117
AN - SCOPUS:79958861318
VL - 52
SP - 1168
EP - 1176
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 6
ER -