Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua: A European survey and analysis of 65 cases

Ruta Mameniskiene, Thomas Bast, Carla Bentes, Maria P. Canevini, Petia Dimova, Tiziana Granata, Hans Høgenhaven, Bosanka Jocic Jakubi, Petr Marusic, Gayane Melikyan, Roberto Michelucci, Konstantin Y. Mukhin, Bernhard Oehl, Francesca Ragona, Andrea O. Rossetti, Guido Rubboli, Susanne Schubert, Ulrich Stephani, Julia Strobel, Aglaia VignoliJana Zarubova, Peter Wolf

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1168-1176
Number of pages9
JournalEpilepsia
Volume52
Issue number6
DOIs
Publication statusPublished - Jun 2011

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

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  • Cite this

    Mameniskiene, R., Bast, T., Bentes, C., Canevini, M. P., Dimova, P., Granata, T., Høgenhaven, H., Jakubi, B. J., Marusic, P., Melikyan, G., Michelucci, R., Mukhin, K. Y., Oehl, B., Ragona, F., Rossetti, A. O., Rubboli, G., Schubert, S., Stephani, U., Strobel, J., ... Wolf, P. (2011). Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua: A European survey and analysis of 65 cases. Epilepsia, 52(6), 1168-1176. https://doi.org/10.1111/j.1528-1167.2010.02974.x