Long-term follow-up of adult patients with genetic generalized epilepsy with typical absence seizures and generalized paroxysmal fast activity in their EEG. 2014

Zeynep Aydin-Özemir, and Zeliha Matur, and Nerses Bebek, and Candan Gürses, and Ayşen Gökyiğit, and Betül Baykan
Istanbul University Epilepsy Center (EPIMER) and Istanbul Faculty of Medicine, Department of Neurology, Clinical Neurophysiology Unit, Turkey; Memorial Ataşehir Hospital, Department of Neurology, Turkey. Electronic address: drzeynepaydin@yahoo.com.

OBJECTIVE Generalized paroxysmal fast activity (GPFA), an EEG pattern with variable frequency and duration, is usually noted in symptomatic/cryptogenic generalized epilepsies. However, GPFA has also been reported in a few patients with genetic generalized epilepsy (GGE) who presented with typical absence seizures (TAS). Our aim was to report the results of long-term follow-up and genetic findings in these patients. METHODS We investigated all EEGs of adult GGE patients with TAS, and identified 12 patients with GPFA (8.3% of adult GGE patients with TAS). Ten of these patients were available for long-term follow up. Their clinical and electroencephalographic courses and genetic features were investigated. The control group was composed of 24 adult GGE patients who also had TAS, but lacking GPFA with a similar follow-up duration in the same epilepsy center. RESULTS The mean age at GPFA detection was 33±16.6 (16-71 years) and 80% still had GPFA in their last EEG. The duration of epilepsy and persistence of TAS were both significantly longer in the GPFA group despite a similar follow-up duration. Sixty percent of the GPFA group had consanguineous parents, whereas this rate was only 4.17% in the control group. Seven relatives of the GPFA group also had epilepsy. We could not show any known mutations in two families. At the end of the follow-up, none of the patients with GPFA was dependent in self-care, despite continuing seizures. CONCLUSIONS Our study shows that GPFA is an ignored EEG pattern of adult GGE patients with TAS, indicating a long and non-remitting course in almost all of the patients.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D003241 Consanguinity The magnitude of INBREEDING in humans. Inbreeding, Human,Consanguineous Marriage,Consanguinous Mating,Consanguineous Marriages,Consanguinities,Consanguinous Matings,Human Inbreeding,Human Inbreedings,Inbreedings, Human,Marriage, Consanguineous,Marriages, Consanguineous,Mating, Consanguinous,Matings, Consanguinous
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004829 Epilepsy, Generalized Recurrent conditions characterized by epileptic seizures which arise diffusely and simultaneously from both hemispheres of the brain. Classification is generally based upon motor manifestations of the seizure (e.g., convulsive, nonconvulsive, akinetic, atonic, etc.) or etiology (e.g., idiopathic, cryptogenic, and symptomatic). (From Mayo Clin Proc, 1996 Apr;71(4):405-14) Convulsive Generalized Seizure Disorder,Epilepsy, Tonic,Generalized Nonconvulsive Seizure Disorder,Seizure Disorder, Generalized,Convulsive Seizure Disorder, Generalized,Epilepsy, Akinetic,Epilepsy, Atonic,Generalized Convulsive Epilepsy,Generalized Nonconvulsive Epilepsy,Generalized Onset Seizure Disorder,Generalized Seizure Disorder, Convulsive,Generalized Seizure Disorder, Nonconvulsive,Nonconvulsive Generalized Seizure Disorder,Nonconvulsive Seizure Disorder, Generalized,Seizure Disorder, Convulsive, Generalized,Seizure Disorder, Generalized Nonconvulsive,Seizure Disorder, Generalized Onset,Seizure Disorder, Generalized, Convulsive,Seizure Disorder, Nonconvulsive Generalized,Symptomatic Generalized Epilepsy,Akinetic Epilepsies,Akinetic Epilepsy,Atonic Epilepsies,Atonic Epilepsy,Convulsive Epilepsies, Generalized,Convulsive Epilepsy, Generalized,Epilepsies, Akinetic,Epilepsies, Atonic,Epilepsies, Generalized,Epilepsies, Generalized Convulsive,Epilepsies, Tonic,Epilepsy, Generalized Convulsive,Epilepsy, Generalized Nonconvulsive,Epilepsy, Symptomatic Generalized,Generalized Convulsive Epilepsies,Generalized Epilepsies,Generalized Epilepsy,Generalized Epilepsy, Symptomatic,Generalized Seizure Disorder,Generalized Seizure Disorders,Nonconvulsive Epilepsy, Generalized,Seizure Disorders, Generalized,Tonic Epilepsies,Tonic Epilepsy
D004832 Epilepsy, Absence A seizure disorder usually occurring in childhood characterized by rhythmic electrical brain discharges of generalized onset. Clinical features include a sudden cessation of ongoing activity usually without loss of postural tone. Rhythmic blinking of the eyelids or lip smacking frequently accompanies the SEIZURES. The usual duration is 5-10 seconds, and multiple episodes may occur daily. Juvenile absence epilepsy is characterized by the juvenile onset of absence seizures and an increased incidence of myoclonus and tonic-clonic seizures. (Menkes, Textbook of Child Neurology, 5th ed, p736) Akinetic Petit Mal,Epilepsy, Minor,Petit Mal Epilepsy,Pyknolepsy,Absence Seizure Disorder,Childhood Absence Epilepsy,Epilepsy Juvenile Absence,Epilepsy, Absence, Atypical,Epilepsy, Petit Mal,Juvenile Absence Epilepsy,Pykno-Epilepsy,Seizure Disorder, Absence,Absence Epilepsy,Absence Epilepsy, Childhood,Absence Epilepsy, Juvenile,Absence Seizure Disorders,Epilepsy, Childhood Absence,Epilepsy, Juvenile Absence,Minor Epilepsy,Petit Mal, Akinetic,Pykno Epilepsy,Pyknolepsies,Seizure Disorders, Absence
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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