neuroogist Hospital El Cruce, Buenos Aires, Argentina
This abstract has been invited to present during the Better Patient Outcomes through Diversity Platform poster session
Rationale: The alteration of consciousness (AOC) during seizures is one of the most striking features in patients with focal epilepsy. Despite conceptual ambiguities, the assessment of consciousness is undeniably fundamental to epileptology but the subjacent mechanisms are incompletely known. Better defining of intracerebral EEG (iEEG) morphological signal could improve the understanding of such mechanisms.The aim of this study was to describe the characteristics of the electrical characteristic of the signal in temporal and extra temporal seizures when the alteration of the consciousness occurs. Methods: It was included 13 patients (58 seizures) with drug resistant epilepsy. All patients had a comprehensive evaluation including detailed history and neurological examination, neuropsychological testing, routine MRI, surface EEG and stereoelectroencephalography (SEEG, depth electrodes). We considered iEEG patterns, localization, size of the cortical cortex and hemisfered compromised. We analyzed iEEG signal at two moments: at the beginning of the seizure and during alteration of consciousness. The consciousness were classified using CSS (Arthius et all, Epilepsia 2012) into without, moderate and profound AOC. Results: The mean age was 28 ± 7 years-old and the mean age at first seizure was 13± 6 years-old. The 64.3% were females. The 42.9% were temporal and 57.1% were extra temporal (without demographic differences between groups) Table 1 Demographic CharacteristicIn temporal epilepsy (n=18 seizures), onset at hippocampus was associated with greater AOC; while the onset at the lateral temporal lobe was associated with seizure without AOC (p= 0,045). We observed a tendency of compromised left hemisphere when the consciousness is affected, without statistical differences.In frontal epilepsy (n=39 seizures), AOC was associated with pre frontal compromised. The cortical surface affected with epilepsy activity sere greater in seizures with severe AOC (p=0,008)There was a trend of greater left or bilateral compromised. We didn't identified hippocampus compromised in those frontal seizures. We did not find an electrical pattern related with AOC in any group.
Conclusions: In our work, the iEEG signal characteristics during AOC were different according epilepsy beginning. In mesial temporal seizures, most of severe AOC seizures were with hippocampus compromised. Meanwhile in frontal seizures the AOC occurred when the area of discharged is bigger, with pre frontal localization without hippocampus compromised.We identified different iEEG characteristics in temporal and extratemporal groups when consciousness were compromise Funding: Please list any funding that was received in support of this abstract.: IBRO International Travel Grant Click here to view image/table
