Clinical features of late-onset partial cryptogenic epilepsy: Toward an idiopathic temporal epilepsy?
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- 作者：Virginie Lambrecq ; C¨¦cile Marchal ; V¨¦ronique Michel ; Dominique Guehl ; Pierre Burbaud ; Alain Rougier
- 关键词：Cryptogenic epilepsy ; Idiopathic epilepsy ; Late-onset epilepsy ; Sleep apnea ; Temporal epilepsy ; Transient epileptic amnesia
- 刊名：Epilepsy & Behavior
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：28
- 期：2
- 页码：168-171
- 全文大小：191 K
文摘
Adult-onset epilepsy is commonly thought to be secondary to a brain lesion. However, the etiology of adult-onset epilepsy remains unknown in approximately 25 % of patients, despite progress in medical and diagnostic tools. In the present study, we investigated whether late-onset partial cryptogenic epilepsies could be subgrouped based on seizure semiology and clinical characteristics. A total of 41 patients with late-onset cryptogenic epilepsy were included, and the corresponding clinical and electrophysiological data were analyzed. The following three clinical subgroups were identified: 1) a group that fulfilled the diagnostic criteria of transient epileptic amnesia (TEA); 2) a group with late-onset cryptogenic epilepsies with a temporal seizure semiology; and 3) a cryptogenic extratemporal group, which was consistent with the categorization of cryptogenic epilepsies, i.e., epilepsies involving unknown lesions. The temporal group showed homogeneous clinical characteristics, especially a rapid evolution and a greater tendency toward generalization and pharmacoresistance compared with the other two groups. Transient epileptic amnesia was associated with a higher frequency of sleep disorders than either of the other groups. Our findings argue for the clinical identification of a subgroup of late-onset temporal epilepsy that might constitute an idiopathic form. The association between TEA and sleep disorders would suggest a possible pathophysiological role of sleep apnea syndromes in TEA.