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Factors predisposing patients with temporal lobe epilepsy to seizure cluster

Document Type : Original Article

Authors

1 Epilepsy Monitoring Unit, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Brain Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: We aimed to identify the potential risk factors associated with seizure clusters in patients with temporal lobe epilepsy (TLE).
Methods: This retrospective cross-sectional study was performed on all the consecutive patients with TLE, who were admitted to the Epilepsy Monitoring Unit (EMU), Loghman-Hakim Hospital, Tehran, Iran. Seizure cluster was defined as three or more habitual seizures occurring within 24 hours, in over 50% of ictal events, with inter-seizure interval of less than 8 hours. The patients’ demographic data, epilepsy duration, seizure frequency, frequency of interictal epileptiform discharges (IEDs), and brain magnetic resonance imaging (MRI) findings were collected
Results: Among a total number of 124 patients with TLE, 62 (50.0%) patients reported seizure clusters. In addition, 44 (37.9%), 42 (36.2%), and 30 (25.9%) patients had normal-appearing brain MRI, mesial temporal sclerosis (MTS), and other brain pathologies, respectively. In terms of IEDs frequency, 35 (29.4%), 43 (36.1%), 17 (14.3%), and 24 (20.2%) patients had respectively frequent, occasional, rare, and no spikes in one-hour of interictal scalp electroencephalography (EEG) recording. In our study, seizure clusters were not associated with the epilepsy duration (P = 0.100), the amount of IEDs (P = 0.764), or MRI findings (P = 0.112).
Conclusion: In patients with TLE, seizure clustering had no correlation with the epilepsy duration, the amount of IEDs, or brain MRI findings.

Keywords

References
  1. Brodie MJ, Barry SJ, Bamagous GA, Norrie JD, Kwan P. Patterns of treatment response in newly diagnosed epilepsy. Neurology 2012; 78(20): 1548-54.
  2. Maglalang PD, Rautiola D, Siegel RA, Fine JM, Hanson LR, Coles LD, et al. Rescue therapies for seizure emergencies: New modes of administration. Epilepsia 2018; 59(Suppl 2): 207-15.
  3. Buelow JM, Shafer P, Shinnar R, Austin J, Dewar S, Long L, et al. Perspectives on seizure clusters: Gaps in lexicon, awareness, and treatment. Epilepsy Behav 2016; 57(Pt A): 16-22.
  4. Haut SR. Seizure clusters: Characteristics and treatment. Curr Opin Neurol 2015; 28(2): 143-50.
  5. Haut SR. Seizure clustering. Epilepsy Behav 2006; 8(1): 50-5.
  6. Haut SR, Lipton RB, LeValley AJ, Hall CB, Shinnar S. Identifying seizure clusters in patients with epilepsy. Neurology 2005; 65(8): 1313-5.
  7. McKee HR, Abou-Khalil B. Outpatient pharmacotherapy and modes of administration for acute repetitive and prolonged seizures. CNS Drugs 2015; 29(1): 55-70.
  8. Detyniecki K, O'Bryan J, Choezom T, Rak G, Ma C, Zhang S, et al. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy Behav 2018; 88: 349-56.
  9. Detyniecki K, Van Ess PJ, Sequeira DJ, Wheless JW, Meng TC, Pullman WE. Safety and efficacy of midazolam nasal spray in the outpatient treatment of patients with seizure clusters-a randomized, double-blind, placebo-controlled trial. Epilepsia 2019; 60(9): 1797-808.
  10. Haut SR, Shinnar S, Moshe SL. Seizure clustering: risks and outcomes. Epilepsia 2005; 46(1): 146-9.
  11. Sinha S, Satishchandra P, Kalband BR, Thennarasu K. New-onset status epilepticus and cluster seizures in the elderly. J Clin Neurosci 2013; 20(3): 423-8.
  12. Sillanpaa M, Schmidt D. Seizure clustering during drug treatment affects seizure outcome and mortality of childhood-onset epilepsy. Brain 2008; 131(Pt 4): 938-44.
  13. Martinez C, Sullivan T, Hauser WA. Prevalence of acute repetitive seizures (ARS) in the United Kingdom. Epilepsy Res 2009; 87(2-3): 137-43.
  14. Fisher RS, Bartfeld E, Cramer JA. Use of an online epilepsy diary to characterize repetitive seizures. Epilepsy Behav 2015; 47: 66-71.
  15. Jobst BC, Williamson PD. Frontal lobe seizures. Psychiatr Clin North Am 2005; 28(3): 635-9.
  16. Komaragiri A, Detyniecki K, Hirsch LJ. Seizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy. Epilepsy Behav 2016; 59: 83-6.
  17. Cereghino JJ. Identification and treatment of acute repetitive seizures in children and adults. Curr Treat Options Neurol 2007; 9(4): 249-55.
  18. Haut SR, Shinnar S, Moshe SL, O'Dell C, Legatt AD. The association between seizure clustering and convulsive status epilepticus in patients with intractable complex partial seizures. Epilepsia 1999; 40(12): 1832-4.
  19. Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2012 version. J Clin Neurophysiol 2013; 30(1): 1-27.
  20. Penovich PE, Buelow J, Steinberg K, Sirven J, Wheless J. Burden of seizure clusters on patients with epilepsy and caregivers: survey of patient, caregiver, and clinician perspectives. Neurologist 2017; 22(6): 207-14.
  21. Ferastraoaru V, Schulze-Bonhage A, Lipton RB, Dumpelmann M, Legatt AD, Blumberg J, et al. Termination of seizure clusters is related to the duration of focal seizures. Epilepsia 2016; 57(6): 889-95.
  22. Bauman K, Devinsky O. Seizure clusters: Morbidity and mortality. Front Neurol 2021; 12: 636045.
  23. Kudlacek J, Chvojka J, Kumpost V, Hermanovska B, Posusta A, Jefferys JGR, et al. Long-term seizure dynamics are determined by the nature of seizures and the mutual interactions between them. Neurobiol Dis 2021; 154: 105347.
  24. Herzog AG, Harden CL, Liporace J, Pennell P, Schomer DL, Sperling M, et al. Frequency of catamenial seizure exacerbation in women with localization-related epilepsy. Ann Neurol 2004; 56(3): 431-4.
  25. Desai B, Whitman S, Bouffard DA. The role of the EEG in epilepsy of long duration. Epilepsia 1988; 29(5): 601-6.
  26. Sundaram M, Hogan T, Hiscock M, Pillay N. Factors affecting interictal spike discharges in adults with epilepsy. Electroencephalogr Clin Neurophysiol 1990; 75(4): 358-60.
  27. Drury I, Beydoun A. Interictal epileptiform activity in elderly patients with epilepsy. Electroencephalogr Clin Neurophysiol 1998; 106(4): 369-73.
  28. Katz A, Marks DA, McCarthy G, Spencer SS. Does interictal spiking change prior to seizures? Electroencephalogr Clin Neurophysiol 1991; 79(2): 153-6.
  29. Krendl R, Lurger S, Baumgartner C. Absolute spike frequency predicts surgical outcome in TLE with unilateral hippocampal atrophy. Neurology 2008; 71(6): 413-8.
  30. Karoly PJ, Freestone DR, Boston R, Grayden DB, Himes D, Leyde K, et al. Interictal spikes and epileptic seizures: their relationship and underlying rhythmicity. Brain 2016; 139(Pt 4): 1066-78.
  31. Haut SR, Swick C, Freeman K, Spencer S. Seizure clustering during epilepsy monitoring. Epilepsia 2002; 43(7): 711-5.
  32. Bauer J, Ghane Y, Flugel D, Wildt L, Stefan H. Etiology, follow-up and therapy of seizure clusters in temporal lobe epilepsy and catamenial epileptic seizures. Schweiz Arch Neurol Psychiatr (1985) 1992; 143(2): 117-34. [In German].
  33. Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, et al. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Res 2017; 133: 98-102.
Current Journal of Neurology
Volume 21, Issue 1
January 2022
Pages 12-16
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