Does the patient's hand hold the key to preventing secondary generalization in mesial temporal lobe epilepsy?

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dc.contributor.authorPedroso Uchida, Carina Goncalves [UNIFESP]
dc.contributor.authorBarsottini, Orlando Graziani Povoas [UNIFESP]
dc.contributor.authorSales Ferreira Caboclo, Luis Otavio [UNIFESP]
dc.contributor.authorAraujo Filho, Gerardo Maria de [UNIFESP]
dc.contributor.authorCenteno, Ricardo Silva [UNIFESP]
dc.contributor.authorCarrete Junior, Henrique [UNIFESP]
dc.contributor.authorTargas Yacubian, Elza Marcia [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:31:56Z
dc.date.available2016-01-24T14:31:56Z
dc.date.issued2013-07-01
dc.description.abstractThis study aimed to analyze the impact of ictal dystonic posturing (DP) in postoperative seizure outcome and to assess the influence of DP in generalized tonic clonic seizure (GTCS) occurrence during video-EEG monitoring of patients with temporal lobe epilepsy with mesial temporal sclerosis. the impact of DP on surgical outcome remains controversial. Moreover, DP has been recently associated with brain networks avoiding GTCS occurrence.Five hundred twenty-seven seizures of 171 patients who were submitted to standard anterior temporal lobectomy (ATL) between 2002 and 2010, with at least one year of post-surgical follow-up, were retrospectively analyzed and classified as with or without DP and as evolving or not to GTCS. the ictal semiologic correlates of DP, timing elapsed since precedent seizure and antiepileptic drug (AED) intake before each seizure were evaluated. Seizure outcome after ATL was assessed according to Engel's scale.Fifty-eight out of 171 patients (34%) exhibited ictal DP, of which 91.5% were always unilateral and contralateral to the operated side. DP was related to shorter seizures (p = 0.007) and a much lower likelihood of the seizure evolving to GTCS (p = 0.001), even during AED withdrawal (p = 0.002). There was no association between DP and prognosis regarding seizure control as the result of the surgical resection, either in patients with shorter or in those with longer period of follow-up. Our data support the hypothesis that DP reflects a brain network activation that helps avoid GTCS, even during AED withdrawal. (C) 2013 Elsevier B.V. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo UNIFESP, Dept Neurol & Neurosurg, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo UNIFESP, Dept Psychiat, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo UNIFESP, Dept Radiol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo UNIFESP, Dept Neurol & Neurosurg, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo UNIFESP, Dept Psychiat, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo UNIFESP, Dept Radiol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.format.extent125-132
dc.identifierhttp://dx.doi.org/10.1016/j.eplepsyres.2013.02.001
dc.identifier.citationEpilepsy Research. Amsterdam: Elsevier B.V., v. 105, n. 1-2, p. 125-132, 2013.
dc.identifier.doi10.1016/j.eplepsyres.2013.02.001
dc.identifier.issn0920-1211
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36482
dc.identifier.wosWOS:000320737500015
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofEpilepsy Research
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectDystonic posturingen
dc.subjectTemporal lobe epilepsyen
dc.subjectMesial temporal sclerosisen
dc.subjectSurgical outcomeen
dc.subjectGeneralized tonic-clonic seizuresen
dc.subjectVideo-EEG monitoringen
dc.titleDoes the patient's hand hold the key to preventing secondary generalization in mesial temporal lobe epilepsy?en
dc.typeinfo:eu-repo/semantics/article
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