scholarly journals Video-EEG illustration of transient episodes of loss of consciousness correlating with plateau-waves due to intracranial hypertension

2020 ◽  
Vol 22 (4) ◽  
pp. 515-516
Author(s):  
Nada El Youssef ◽  
Vadim Ivanov ◽  
Agnes Trebuchon ◽  
Fabrice Bartolomei ◽  
Stanislas Lagarde
Keyword(s):  
Intracranial Hypertension ◽  
Loss Of Consciousness ◽  
Plateau Waves ◽  
Video Eeg

Utility of CSF Pressure Monitoring to Identify Idiopathic Intracranial Hypertension without Papilledema in Patients with Chronic Daily Headache

Cephalalgia ◽  
2004 ◽  
Vol 24 (6) ◽  
pp. 495-502 ◽  
Author(s):  
MT Torbey ◽  
RG Geocadin ◽  
AY Razumovsky ◽  
D Rigamonti ◽  
MA Williams
Keyword(s):  
Intracranial Hypertension ◽  
Chronic Daily Headache ◽  
Idiopathic Intracranial Hypertension ◽  
Pulse Amplitude ◽  
Shunt Insertion ◽  
Csf Drainage ◽  
Plateau Waves ◽  
Objective Evidence ◽  
Diagnostic Role ◽  
Daily Headache

The aim of the present study was to report on the utility of continuous Pcsf monitoring in establishing the diagnosis of idiopathic intracranial hypertension without papilledema (IIHWOP) in chronic daily headache (CDH) patients. We report a series of patients ( n = 10) with refractory headaches and suspected IIHWOP referred to us for continuous Pcsf monitoring between 1991 and 2000. Pcsf was measured via a lumbar catheter and analysed for mean, peak, highest pulse amplitude and abnormal waveforms. A 1-2 day trial of continuous controlled CSF drainage (10 cc/h) followed Pcsf monitoring. Response to CSF drainage was defined as improvement in headache symptoms. Patients with abnormal waveforms underwent a ventriculoperitoneal (VPS) or lumboperitoneal (LPS) shunt insertion. All patients had normal resting Pcsf (8 ± 1 mmHg) defined as ICP < 15 mmHg. During sleep, all patients had B-waves and 90% had plateau waves or near plateau waves. All patients underwent either a VPS or LPS procedure. All reported improvement of their headache after surgery. Demonstration of pathological Pcsf patterns by continuous Pcsf monitoring was essential in confirming the diagnosis of IIHWOP, and provided objective evidence to support the decision for shunt surgery. Increased Pcsf was seen mostly during sleep and was intermittent, suggesting that Pcsf elevation may be missed by a single spot-check LP measurement. The similarity between IIHWOP and CDH suggests that continuous Pcsf monitoring in CDH patients may have an important diagnostic role that should be further investigated.

scholarly journals Cerebral Blood Flow During Plateau Waves in a Patient With Benign Intracranial Hypertension. Case Report.

2000 ◽  
Vol 40 (5) ◽  
pp. 287-292 ◽  
Author(s):  
Ryusuke KABEYA ◽  
Suguru INAO ◽  
Masanori TADOKORO ◽  
Masanari NISHINO ◽  
Jun YOSHIDA
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Case Report ◽  
Intracranial Hypertension ◽  
Benign Intracranial Hypertension ◽  
Plateau Waves

Differentiating motor phenomena in tilt-induced syncope and convulsive seizures

Neurology ◽  
2018 ◽  
Vol 90 (15) ◽  
pp. e1339-e1346 ◽  
Author(s):  
Sharon Shmuely ◽  
Prisca R. Bauer ◽  
Erik W. van Zwet ◽  
J. Gert van Dijk ◽  
Roland D. Thijs
Keyword(s):  
Blood Pressure ◽  
Differential Diagnosis ◽  
Convulsive Seizure ◽  
Loss Of Consciousness ◽  
Blood Pressure Decrease ◽  
Pressure Decrease ◽  
Eeg Changes ◽  
Eeg Recordings ◽  
Convulsive Seizures ◽  
Video Eeg

ObjectiveWe assessed motor phenomena in syncope and convulsive seizures to aid differential diagnosis and understand the pathophysiologic correlates.MethodsWe studied video-EEG recordings of tilt-induced syncope and convulsive seizures in participants aged 15 years and older. Syncope was defined as (1) loss of consciousness (video-assessed), (2) circulatory changes (accelerating blood pressure decrease with or without bradycardia/asystole), and (3) EEG changes (“slow” or “slow-flat-slow”). We assessed myoclonic jerks and tonic postures of the arms and noted time of occurrence, laterality, synchrony, and rhythmicity (mean consecutive differences of interclonic intervals).ResultsVideo-EEG records of 65 syncope cases and 50 convulsive seizures were included. In syncope, postures occurred in 42 cases (65%) and jerks in 33 (51%). Fewer jerks occurred in syncope (median 2, range 1–19) compared to convulsive seizures (median 48, range 20–191; p < 0.001). Jerks were more rhythmic in seizures compared to syncope (p < 0.001). Atonia was seen in all syncope cases, while this was not observed in any seizure. Jerks predominantly occurred during the slow and postures during the flat EEG phase.ConclusionsJerks and tonic postures were common in syncope, but semiology differed from convulsive seizures. The lack of overlap in the number of jerks suggests that less than 10 indicates syncope and more than 20 a convulsive seizure: the “10/20 rule.” Loss of tone strongly favors syncope. The EEG correlates imply that jerks in syncope are likely of cortical origin, whereas tonic postures may result from brainstem disinhibition.

scholarly journals Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring Unit

2020 ◽  
Vol 10 (7) ◽  
pp. 443
Author(s):  
Sara Casciato ◽  
Pier Paolo Quarato ◽  
Addolorata Mascia ◽  
Alfredo D’Aniello ◽  
Vincenzo Esposito ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Rare Event ◽  
Cardiac Risk ◽  
Loss Of Consciousness ◽  
Drug Resistant ◽  
Seizure Onset ◽  
Presurgical Evaluation ◽  
History Of ◽  
Epilepsy Monitoring ◽  
Video Eeg

Background: Ictal asystole (IA) is a rare event observed in people with epilepsy (PwE). Clinical and IA video-electroencephalographic findings may be helpful in screening for high-risk subjects. Methods: From all PwE undergoing video-EEG for presurgical evaluation between 2000 and 2019, we retrospectively selected those with at least one IA (R–R interval of ≥3 s during a seizure). Results: IA was detected in eight out of 1088 (0.73%) subjects (mean age: 30 years; mean epilepsy duration: 9.6 years). Four out of them had a history of atonic falls. No patients had cardiac risk factors or cardiovascular diseases. Seizure onset was temporal (n = 5), temporo-parietal (n = 1) or frontal (n = 2), left-sided and right-sided in five and two patients, respectively. In one case a bilateral temporal independent seizure onset was recorded. IA was recorded in 11 out of 18 seizures. Mean IA duration was 13 s while mean IA latency from seizure onset was 26.7 s. Symptoms related to IA were observed in all seizures. Conclusion: IA is a rare and self-limiting event often observed during video-EG in patients with a history of atonic loss of consciousness and/or tardive falls in the course of a typical seizure.

scholarly journals 0444: Usefulness of combined head-up tilt testing with video-EEG monitoring in the evaluation of patients with atypical seizure-like unexplained loss of consciousness

2015 ◽  
Vol 7 (1) ◽  
pp. 75
Author(s):  
Claude Kouakam ◽  
William Szurhaj ◽  
Laurence Guédon-Moreau ◽  
Christine Monpeurt ◽  
Dominique Lacroix ◽  
...  
Keyword(s):  
Loss Of Consciousness ◽  
Eeg Monitoring ◽  
Tilt Testing ◽  
Head Up Tilt ◽  
Video Eeg

scholarly journals Recurrent seizures in a young woman: when video-EEG diagnoses a cardiac cause: a case report

2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Corentin Chaumont ◽  
Julie Bourilhon ◽  
Nathalie Chastan ◽  
Adrian Mirolo ◽  
Hélène Eltchaninoff ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
Loss Of Consciousness ◽  
Escape Rhythm ◽  
Cerebral Dysfunction ◽  
Psychosocial Consequences ◽  
Transient Loss ◽  
True Condition ◽  
Drug Resistant Epilepsy ◽  
Video Eeg

Abstract Background While transient loss of consciousness is a frequent presenting symptom, differential diagnosis between syncope and epilepsy can be challenging. Misdiagnosis of epilepsy leads to important psychosocial consequences and eliminates the opportunity to treat patient’s true condition. Case summary A 39-year-old woman presenting with recurrent seizures since her childhood was referred to neurological consultation. Electroencephalograms (EEGs) and magnetic resonance imaging previously performed were normal. A sleep-deprived video-EEG was performed and highlighted after 12 h of sleep deprivation a progressive dropping of the heart rate followed by a complete heart block without ventricular escape rhythm and asystole for about 30 s. Her EEG recording later showed diffuse slow waves traducing a global cerebral dysfunction and suffering. The diagnosis of vaso-vagal syncope with predominant cardioinhibitory response was made and a dual-chamber pacemaker with rate-drop response algorithm was implanted. After a 2 years of follow-up, the patient remained free of syncope. Discussion Patients presenting with loss of consciousness and convulsion are often diagnosed with epilepsy despite normal EEGs. In patients presenting with recurrent seizures with unclear diagnosis of epilepsy or in a situation of drug-resistant epilepsy, syncope diagnosis should always be considered and a risk stratification is necessary. The benefit of pacemaker implantation in patients with recurrent vaso-vagal syncope is still very controversial. Only patients presenting with spontaneous asystole should be considered for pacemaker implantation in case of recurrent vaso-vagal syncope.

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