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Soheyl Noachtar - One of the best experts on this subject based on the ideXlab platform.
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does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysalkirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Objective: This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 +/- 17.5 (18-97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results: The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS 24 h), low Glasgow Coma Scale (GCS) ( = 3) were associated with poor short-term outcome and death (p < 0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp[b]: 4.74 and 4.10 respectively, p < 0.05). Conclusion: Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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Does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysal-kirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Abstract Objective This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 ± 17.5 (18–97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS ≤ 3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (> 24 h), low Glasgow Coma Scale (GCS) (≤ 8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥ 3) were associated with poor short-term outcome and death (p Conclusion Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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seizure Semiology identifies patients with bilateral temporal lobe epilepsy
Epilepsy Research, 2015Co-Authors: Anna Mira Loesch, Irsel F Tezer, Elisabeth Hartl, Christian Vollmar, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Summary Objective Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure Semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. Methods We investigated the seizure Semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure Semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Results Bitemporal lobe epilepsy patients had more frequently different seizure Semiology (100% vs. 40%; p Significance The analysis of seizure Semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE.
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Video analysis for defining the symptomatogenic zone
Handbook of Clinical Neurophysiology, 2003Co-Authors: Soheyl NoachtarAbstract:Publisher Summary This chapter discusses the use of video analysis of epileptic seizures to localize and lateralize the symptomatogenic zone in patients with epilepsy. Modern video techniques allow looking at a given seizure repeatedly and investigating its features. Such analysis of epileptic seizures documented by means of simultaneous video and electroencephalography recordings have dramatically improved the knowledge of epileptic seizure Semiology. Special effects, such as slow motion and zoom further facilitate analysis. Nevertheless, the fact that seizure analysis is performed visually and is heavily dependent on the description of observers means that it may be biased or subject to errors. Quantitative analysis of movements during video-recorded seizures may help to develop objective criteria for the analysis of seizure Semiology. Localizing significance of different seizure types is discussed in the chapter.
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epileptic seizures pathophysiology and clinical Semiology
2000Co-Authors: Hans Lüders, Soheyl NoachtarAbstract:PART I PATHOGENESIS of EPILEPTIC SEIZURES Experimental Neurophysiology of Epileptic Seizures. Non-Invasive Ictal EEG Recordings. Invasive Ictal EEG Recordings. Ictal SPECT. Ictal PET. Cortical Stimulation and Pathogenesis of Ictal Semiology PART II ICTAL Semiology Classification of Epileptic Seizures. Auras. Somatosensory Auras. Visual Auras. Gustatory Auras. Olfactory Auras. Experiential Auras. Abdominal Auras. Absence Seizures. Psychomotor Seizures. Hypermotor Seizures. Motor Seizures. Clonic Seizures. Tonic Seizures. Tonic-Clonic Seizures. Myoclonic Seizures. Atonic Seizures. Seizure Evolutions
Christoph Baumgartner - One of the best experts on this subject based on the ideXlab platform.
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combining ictal surface electroencephalography and seizure Semiology improves patient lateralization in temporal lobe epilepsy
Epilepsia, 2000Co-Authors: W Serles, Gerald Lindinger, Ekaterina Pataraia, Zografos Caramanos, Christoph BaumgartnerAbstract:Purpose: The study goal was to assess the concordance of ictal surface-EEG and seizure Semiology data in lateralizing intractable temporal lobe epilepsy (TLE) and to examine the benefits of the combined use of these two methods. Methods: We independently analyzed the ictal recordings and clinical symptoms associated with 262 seizures recorded in 59 TLE patients. Each seizure was lateralized on the basis of (i) its associated ictal surface-EEG pattern according to a predefined lateralization protocol and (ii) its associated ictal and postictal seizure Semiology according to strictly defined clinical criteria. Individual patients were also lateralized based on these data. Results: Ictal surface-EEG findings lateralized 62.6% of seizures and 64.4% of patients. Seizure Semiology findings lateralized 46.2% of seizures and 78.0% of patients. There was a high degree of concordance between lateralizations based on these two methods, for both individual seizures and individual patients. Combination of the information from the two methods allowed for lateralization in a greater proportion of both seizures (79.8%) and patients (94.9%). Combined EEG-seizure lateralization was concordant with the side of operation in 33 of 34 patients who underwent successful surgery (Engel's surgical outcome class I/II). Conclusions: In TLE, there is a high agreement between the lateralization of individual seizures and patients, which is based on ictal surface-EEG findings and seizure Semiology. Furthermore, combination of these two methods improves the lateralization of individual seizures and patients. Thus, standardized combined EEG-seizure analysis is a valuable noninvasive tool in the presurgical evaluation of TLE.
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cluster analysis of clinical seizure Semiology of psychogenic nonepileptic seizures
Epilepsia, 2000Co-Authors: G Groppel, T Kapitany, Christoph BaumgartnerAbstract:Summary: Purpose: To develop an objective classification of psychogenic nonepileptic seizures (NES) based on cluster analysis of clinical seizure Semiology. Methods: We studied the clinical seizure Semiology in 27 patients with psychogenic NES documented by prolonged video-EEC monitoring. We analyzed the following clinical symptoms: clonic and hypermotor movements as well as trembling of the upper and/or lower extremities, pelvic thrusting, head movements, tonic posturing backward of the head, and falling. We used cluster analysis to identify symptoms occurring together in a systematic way and thus tried to achieve a clinical classification of psychogenic NES. Results: We could identify three symptom clusters. Cluster 1 was characterized by clonic and hypermotor movements of the extremities, pelvic thrusting, head movements, and tonic posturing of the head, and therefore was named “psychogenic motor seizures.” Cluster 2 comprised trembling of the upper and lower extremities and was termed “psychogenic minor motor or trembling seizures.” Cluster 3 consisted of falling to the floor as the only symptom and was referred to as “psychogenic atonic seizures.” Conclusions: Our study represents the first study to analyze the clinical Semiology of psychogenic NES by cluster analysis, which should be useful for an objective classification of psychogenic NES. This classification should allow both a better characterization of psychogenic NES and an easier differential diagnosis against specific epileptic seizures.
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a new epileptic seizure classification based exclusively on ictal Semiology
Acta Neurologica Scandinavica, 1999Co-Authors: Hans Lüders, Jayant Acharya, Adrian Ebner, Selim R. Benbadis, Nancy Foldvary, Christoph Baumgartner, Andrew Bleasel, Richard C. Burgess, Dudley S. Dinner, Eric B. GellerAbstract:Historically, seizure Semiology was the main feature in the differential diagnosis of epileptic syndromes. With the development of clinical EEG, the definition of electroclinical complexes became an essential tool to define epileptic syndromes, particularly focal epileptic syndromes. Modern advances in diagnostic technology, particularly in neuroimaging and molecular biology, now permit better definitions of epileptic syndromes. At the same time detailed studies showed that there does not necessarily exist a one-to-one relationship between epileptic seizures or electroclinical complexes and epileptic syndromes. These developments call for the reintroduction of an epileptic seizure classification based exclusively on clinical Semiology, similar to the seizure classifications which were used by neurologists before the introduction of the modem diagnostic methods. This classification of epileptic seizures should always be complemented by an epileptic syndrome classification based on all the available clinical information (clinical history, neurological exam, ictal Semiology, EEG, anatomical and functional neuroimaging, etc.). Such an approach is more consistent with mainstream clinical neurology and would avoid the current confusion between the classification of epileptic seizures (which in the International Seizure Classification is actually a classification of electroclinical complexes) and the classification of epileptic syndromes.
Hans Lüders - One of the best experts on this subject based on the ideXlab platform.
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Epileptic seizure Semiology in different age groups
Epileptic Disorders, 2018Co-Authors: Guadalupe Fernandezbaca Vaca, Jun T Park, Carlos L. Mayor, Naira García Losarcos, Hans LüdersAbstract:Seizure Semiology provides information about the eloquent cortex involved during a seizure and helps to generate a hypothesis regarding the localization of the epileptogenic zone (EZ), a prerequisite for surgical management of epilepsy. We aimed to study the seizure Semiology among all different age groups to better characterize semiological changes that occur with age. We performed a retrospective review of video-EEG data in paediatric and adult patients admitted to the Epilepsy Monitoring Unit over a three-year period. Authors independently reviewed and classified the seizure Semiology while blinded to clinical, EEG, and neuroimaging data. A total of 270 patients were included in the study. The most frequent EZ in patients who were one month to three years old was undetermined. Focal epilepsy became more frequent in patients older than 10 years. Among patients with focal epilepsy, a posterior quadrant EZ was most frequent in children younger than three years old, a temporal EZ between three and six years old, and a frontal EZ between six and 10 years old. The temporal lobe was the most frequent location for focal EZ in patients older than 18 years. Auras, automotor seizures, and generalized tonic-clonic seizures were extremely infrequent in patients younger than 10 years old. The youngest patient with auras was 5.7 years old. The youngest patient with automotor seizures was 3.7 years old. We identified only three patients with generalized tonic-clonic seizures who were younger than 10 years (aged six months, 6.6 years, and nine years, respectively). Patients younger than three years exhibited mostly generalized simple motor seizures and hypomotor seizures. Generalized epileptic spasms, generalized tonic seizures, and generalized clonic seizures were infrequent in patients older than 10 years. Seizure Semiology and electroencephalographic changes most likely reflect the maturation of cortical functions.
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epileptic seizures pathophysiology and clinical Semiology
2000Co-Authors: Hans Lüders, Soheyl NoachtarAbstract:PART I PATHOGENESIS of EPILEPTIC SEIZURES Experimental Neurophysiology of Epileptic Seizures. Non-Invasive Ictal EEG Recordings. Invasive Ictal EEG Recordings. Ictal SPECT. Ictal PET. Cortical Stimulation and Pathogenesis of Ictal Semiology PART II ICTAL Semiology Classification of Epileptic Seizures. Auras. Somatosensory Auras. Visual Auras. Gustatory Auras. Olfactory Auras. Experiential Auras. Abdominal Auras. Absence Seizures. Psychomotor Seizures. Hypermotor Seizures. Motor Seizures. Clonic Seizures. Tonic Seizures. Tonic-Clonic Seizures. Myoclonic Seizures. Atonic Seizures. Seizure Evolutions
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Semiological seizure classification: relevance to pediatric epilepsy
Epileptic disorders : international epilepsy journal with videotape, 2000Co-Authors: Jocelyn F. Bautista, Hans LüdersAbstract:The selection of terminology, though seemingly unimportant, can have profound effects on our thinking. A seizure classification system based exclusively on seizure Semiology emphasizes the wide diversity and richness of seizure expression. In the field of epilepsy surgery, the use of a seizure classification system that emphasizes ictal Semiology in an invaluable first step in the precise localization of ictal onset. This proves to be particularly true in pediatric epilepsy, because seizure Semiology is more subtle and difficult to characterize. The following article describes a semiological seizure classification and its relevance to both pediatric epilepsy surgery and status epilepticus.
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a new epileptic seizure classification based exclusively on ictal Semiology
Acta Neurologica Scandinavica, 1999Co-Authors: Hans Lüders, Jayant Acharya, Adrian Ebner, Selim R. Benbadis, Nancy Foldvary, Christoph Baumgartner, Andrew Bleasel, Richard C. Burgess, Dudley S. Dinner, Eric B. GellerAbstract:Historically, seizure Semiology was the main feature in the differential diagnosis of epileptic syndromes. With the development of clinical EEG, the definition of electroclinical complexes became an essential tool to define epileptic syndromes, particularly focal epileptic syndromes. Modern advances in diagnostic technology, particularly in neuroimaging and molecular biology, now permit better definitions of epileptic syndromes. At the same time detailed studies showed that there does not necessarily exist a one-to-one relationship between epileptic seizures or electroclinical complexes and epileptic syndromes. These developments call for the reintroduction of an epileptic seizure classification based exclusively on clinical Semiology, similar to the seizure classifications which were used by neurologists before the introduction of the modem diagnostic methods. This classification of epileptic seizures should always be complemented by an epileptic syndrome classification based on all the available clinical information (clinical history, neurological exam, ictal Semiology, EEG, anatomical and functional neuroimaging, etc.). Such an approach is more consistent with mainstream clinical neurology and would avoid the current confusion between the classification of epileptic seizures (which in the International Seizure Classification is actually a classification of electroclinical complexes) and the classification of epileptic syndromes.
Berend Feddersen - One of the best experts on this subject based on the ideXlab platform.
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Does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysal-kirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Abstract Objective This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 ± 17.5 (18–97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS ≤ 3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (> 24 h), low Glasgow Coma Scale (GCS) (≤ 8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥ 3) were associated with poor short-term outcome and death (p Conclusion Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysalkirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Objective: This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 +/- 17.5 (18-97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results: The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS 24 h), low Glasgow Coma Scale (GCS) ( = 3) were associated with poor short-term outcome and death (p < 0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp[b]: 4.74 and 4.10 respectively, p < 0.05). Conclusion: Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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seizure Semiology identifies patients with bilateral temporal lobe epilepsy
Epilepsy Research, 2015Co-Authors: Anna Mira Loesch, Irsel F Tezer, Elisabeth Hartl, Christian Vollmar, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Summary Objective Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure Semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. Methods We investigated the seizure Semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure Semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Results Bitemporal lobe epilepsy patients had more frequently different seizure Semiology (100% vs. 40%; p Significance The analysis of seizure Semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE.
Jan Rémi - One of the best experts on this subject based on the ideXlab platform.
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Does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysal-kirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Abstract Objective This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 ± 17.5 (18–97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS ≤ 3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (> 24 h), low Glasgow Coma Scale (GCS) (≤ 8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥ 3) were associated with poor short-term outcome and death (p Conclusion Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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does Semiology of status epilepticus have an impact on treatment response and outcome
Epilepsy & Behavior, 2018Co-Authors: Leyla Baysalkirac, M Einhellig, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Objective: This study investigated whether there is an association between Semiology of status epilepticus (SE) and response to treatment and outcome. Method: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 +/- 17.5 (18-97) years. Patient demographics, SE Semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus Semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results: The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS 24 h), low Glasgow Coma Scale (GCS) ( = 3) were associated with poor short-term outcome and death (p < 0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp[b]: 4.74 and 4.10 respectively, p < 0.05). Conclusion: Status epilepticus Semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
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seizure Semiology identifies patients with bilateral temporal lobe epilepsy
Epilepsy Research, 2015Co-Authors: Anna Mira Loesch, Irsel F Tezer, Elisabeth Hartl, Christian Vollmar, Berend Feddersen, Jan Rémi, Soheyl NoachtarAbstract:Summary Objective Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure Semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. Methods We investigated the seizure Semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure Semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Results Bitemporal lobe epilepsy patients had more frequently different seizure Semiology (100% vs. 40%; p Significance The analysis of seizure Semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE.
