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Long Term Monitoring Peri-Ictal lateralizing signs

Long Term Monitoring Peri-Ictal lateralizing signs. Mahmoud Motamedi, MD. Neurology Department, Sina hospital, Tehran University of Medical Sciences. Focal epilepsies Anatomic localization. Seizure focus can be at considerable distance from symptomatic zone

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Long Term Monitoring Peri-Ictal lateralizing signs

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  1. Long Term MonitoringPeri-Ictal lateralizing signs Mahmoud Motamedi, MD. Neurology Department, Sina hospital, Tehran University of Medical Sciences

  2. Focal epilepsies Anatomic localization Seizure focus can be at considerable distance from symptomatic zone Propagation of Ictal patterns are variable Seizures may be originated from silent brain regions No signs or symptoms can be considered pathogonomonic of the anatomic localization Combining semiologic, electrophysiologic, neuroimaging, and other data provide important localizing information

  3. complexpartialseizures(CPSs) CPSs refers to a partial - onset seizure with impairment of consciousness, (ILAE,1981). Seizures associated with MTLE are more correctly referred to as limbic seizures, whether or not consciousness is impaired

  4. Peri-ictal lateralizing signs (LSs) • LSs may help in presurgical evaluation of adults and young and preverbal children • Some LSs consistently lateralize seizure onset in all ages and some only at the end of first decade. • Some LSs have a high predictive values • Because of testing difficulties assessing some LSs is difficult in children • Are observed more frequently in older children • Lack of LSs occur more frequently among younger children. (<6.7 years)

  5. Long Term Monitoring Ictal lateralizing signs Focal clonic activity Unilateral dystonic / tonic posturing Ictal speech Speech arrest Automatisms with preserved awareness Ictal vomiting Version of head and or eyes Smiling, crying, spiting Unilateral blinking or fluttering

  6. Long Term Monitoring post-ictal lateralizing signs Todd’s paralysis Language disturbances Facial wiping Nose wiping

  7. Predictive value of different ictal lateralizing signs

  8. Predictive value of different postictal lateralizing signs

  9. Peri-Ictal LSs which have no significant differences with respect to patient’s age Unilateral tonic seizures Unilateral clonic seizures Nystagmus Todd’s paralysis Postictal nose wiping

  10. Peri-Ictal LSs which observe more frequently in older children Unilateral manual automatism Dystonic posturing Version Postictal facial wiping Postictal dysphasia

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