Abstracts

Rationale: Tourette’s syndrome (TS) is relatively common biological genetic disorder with a broad spectrum of neurobehavioural manifestations, characterized by multiple motor and vocal tics. Accesory symptoms include coprophenomenea and obsessive compulsive behaviours. Simple tics may be mistaken for myoclonic epilepsy and complex tics for focal seizures Epilepsy associated to TS is exceptional and only occasional reports exist. We aimed to describe a eight cases of TS witch developed focal epilepsy and EEG abnormalities related to. Methods: This study was carried out in our Epilepsy Center. We describe eight patients (mean age 14,5) with Tourette’s syndrome, according to Diagnostic and statistical Manual IV , who developed epilepsy. Parents and both affected parents were interviewed, and general and neurological physical examination was performed. All underwent to prolonged awake and sleep polygraphic video-electroenecephalography study and high quality brain MRI , based on a protocol routinely used, including (axial and coronal slices) T2-weighted images, FLAIR and proton density, T1 inversion recovery with and without administration of gadolinium. Diagnosis of febrile seizures or epilepsy was made according to the Commission on Classification and terminology of the International League against Epilepsy . Results: Four/eight patients had family history motor disorder or epilepsy. Four of our patients had personal histories of febrile convulsion. All eight patients had focal seizures during awake state, described as motor seizure with contact loss, with a low seizures frequency. EEG recording showed normal background activity with epileptic abnormalities in all , except one . LEV and or VPA therapy was introduced, with seizure control. Brain MRI study was normal Mild mental (mean IQ 82) delay was present in Conclusions: Controversy exist over pathophysiology of Tourette’s syndrome(TS) and comorbidity with epilepsy address us to puzzle that epilepsy, although rare, could a part of a phenotype associated to TS. In this way identifying genes that influence development of seizures in complex genetic medical disorder may provide insight into mechanisms of epileptogenesis