ICTAL HAND ATAXIA AS INITIAL MANIFESTATION OF PARIETAL LOBE SEIZURES
Abstract number :
2.086
Submission category :
Year :
2002
Submission ID :
437
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Maria-Paola Valenti, Ahmed Bourazza, Anne Thibault-Menard, Serge Chassagnon, Benoit Lhermitte, Frederic Blanc, Edouard Hirsch. Epilepsy Unit, Neurology, Strasbourg, Alsace, France
RATIONALE: Parietal lobe seizures are rarely reported (1). Clinical manifestations are heterogeneous including somatosensory (paresthetic, painful), apraxia, disturbances of body image. Ictal symptomatology reflects often a propagation to : central (asymetric tonic or clonic phenomena), temporal (dialeptic, automotor, auditory hallucinations), occipital regions (visual hallucinations or illusions. We report two patients with ictal ataxia as initial signs of parietal lobe seizures documented by EEG-video.
METHODS: Two patients aged of 12 and 15 years with refractory partial epilepsy were studied. Video-EEG, morphological and functional neuroimaging were performed as presurgical investigations.
RESULTS: Ten seizures were recorded. Paroxysmal left hand ataxia was the initial predominant sign followed by painful paresthesia in one case. No tonic or clonic motor phenomena were observed suggesting central seizure propagation. Interictal and ictal EEG features were consistent with parietal origin. MRI in one patient suggested underlying focal cortical dysplasia.
CONCLUSIONS: Our cases point out, the existence of ictal hand ataxia as initial sign of parietal lobe seizure onset. Such sign should be identify prior invasive SEEG-video investigations in presurgical drug-resistant epilepsies.