A study of clinical and EEG patterns in patients with Idiopathic generalized epilepsy
Journal Title: Medpulse International Journal of Medicine - Year 2017, Vol 4, Issue 1
Abstract
Background: Idiopathic generalized epilepsies (IGE) are a group of disorders in which EEG shows generalized, bilateral, synchronous, symmetrical spike wave complex and constitute one third of all epilepsies. Patients with IGE have normal neurological status in inter-ictal period and no abnormality on brain imaging. Inter-ictal EEG shows normal background and generalized discharges such as spikes, polys-pikes, poly-spike/spike and waves. 1In developing countries like India, focal seizures due to Tuberculoma, Neurocysticercosis and scar are common, but idiopathic generalized epilepsy still forms a measurable bulk ontributing to seizure morbidity. IGE can have focal discharges in addition to generalized discharges adding to the confusion.2 Thus, it is important to know about the clinical and EEG features of IGE, as treatment and prognosis varies. Aims and Objectives: To study clinical and EEG patterns in patients with Idiopathic Generalized Epilepsy. Methodology: This was a cross-sectional retrospective study in patients with Idiopathic Generalized epilepsy at the Department of Neurology at tertiary health care center during one year period i.e. January 2016 to January 2017 as regards to their seizure types, EEG patterns and syndromic epilepsy diagnosis. Sleep and Awake EEG were done for at least 30 minutes. Those with normal EEG on first time; underwent repeat sleep and awake EEG for 60 minutes. The data was presented in the tabular form and expressed in percentages. Results: 65 patients with IGE above the age of 5 years were included in the study. The majority of the patients were in the age group of 16-30 years (44.62%), followed by 31-45 years (23.07%); 6-15 years (18.46%); 46-60 years (13.84%); Females (61.54%) were more affected than males (38.46%). Various types seizure patterns were GTCS alone in 23.08% followed by Absences alone in 20.00%, GTCS + myoclonic jerksin 13.85%, GTCS + absences in 12.31%, Myoclonic jerks in 7.69%, Absences and myoclonus in 6.15%, GTCS + absences + myoclonic jerks in 6.15%, Atonic drop in 4.62%, Atonic drop and myoclonic jerks in 3.08%, Atonic drop and absence in 3.08%. EEG pattern was Abnormal in 81.54% and normalin 18.46% even with repeated EEG studies. Focal discharges were seen in 32.30% of patients, predominantly from frontocentral region. The focal discharges were unilateral in 71.42% cases and were synchronous bilateral in the remaining 28.57%.Occipital rhythmic intermittent delta activity (ORIDA) was seen in 15.4% patients. Photic stimulation accentuated discharges in all 14 patients with JME whereas hyperventilation induced discharges in 92.3%of childhood absence epilepsy. Abortive generalized bursts of discharges (<2 seconds) constituted 53.08% of abnormal generalized EEG pattern whereas in the remaining 46.92%, bursts were more than 2seconds. Poly-spike, spike wave discharges were seen exclusively with JME. Conclusions: It can be concluded from our study that the majority of the patients were in the age group of 15-30 and majority were females. Most common seizure types were GTCs alone followed by absences alone followed by GTC + myoclonic jerks. Focal discharges can be seen with IGE, mostly from the frontocentral region. Also ORIDA can be seen in generalized epilepsy particularly CAE. Polyspike discharges are exclusively seen with JME.
Authors and Affiliations
Soni Girish, Jagiasi Kamlesh, Singh Rakesh
Keywords
Related Articles
- EP ID EP258373
- DOI -
- Views 54
- Downloads 0
Study of various aetiological factors and clinical patterns of anaemia
Present study was undertaken at general hospital, Solapur. To study various aetiological factors and clinical patterns of anaemia’s. The study included 100 consecutive patients (50 males, 50 females), with age ranging fr...
Study of supervision by household members in the prevention of defaults of the patients taking short course chemotherapy for pulmonary tuberculosis
Background: The default is the biggest challenge in TB control due to the length and complexity of TB treatment. A key component of the DOTS strategy for tuberculosis control is direct observation of treatment. Supervisi...
A study of utility of mantoux test in the suspected cases of tuberculosis at a tertiary health care center
Background: Tuberculosis (TB) in India accounts for the one-fourth of the global cases, adding almost 2.8 million cases annually. Aims: 1) To study the prevalence of tuberculin sensitivity among suspected tuberculosis pa...
Profile of patients with acute febrile illness and multi - organ involvement during monsoon at rural coastal region of Maharashtra
Background: Acute febrile illness (AFI) is defined as a patient with fever of 38°C or higher at presentation or history of fever that persisted for 2–7 days with no localizing source. Fever is the main clinical symptom o...
A study of various complications of right ventricular infarction at tertiary health care centre
Background: Myocardial infarction was previously thought to be a disease of mainly the left ventricle. Right ventricular infarction was just a pathological entity. Aims and Objectives: To Study various complications of r...