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Startle provoked epileptic seizures:features in 19 patients | JoVE Visualize

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Startle provoked epileptic seizures:features in 19 patients

M R Manford¹, D R Fish, S D Shorvon

¹Wessex Neurological Centre, Southampton General Hospital, Hampshire, UK.

Journal of Neurology, Neurosurgery, and Psychiatry|August 1, 1996

View abstract on PubMed

Summary

Startle provoked epileptic seizures (SPES) are more common than previously thought and can occur without lasting deficits. Occult congenital lesions in specific brain areas often cause these seizures.

Area of Science:

Neurology
Epileptology
Neuroimaging

Background:

Startle provoked epileptic seizures (SPES) are a specific epilepsy subtype.
Understanding their clinical presentation and underlying causes is crucial for diagnosis and management.

Purpose of the Study:

To define the clinical characteristics of patients experiencing startle provoked epileptic seizures (SPES).
To investigate the potential underlying etiologies and neuroimaging findings associated with SPES.

Main Methods:

Nineteen patients with SPES were identified and evaluated.
Clinical seizure accounts, interictal EEG, video-EEG-telemetry, CT, and high-resolution MRI were utilized.
Neuroimaging included CT and MRI to assess for structural brain abnormalities.

Main Results:

SPES onset was typically in childhood or adolescence, triggered mainly by sudden noise.
Asymmetric tonic posturing was the common seizure pattern; neurological deficits were not always present.
Neuroimaging revealed dysplastic lesions in the lateral premotor and perisylvian cortices in several patients.

Conclusions:

SPES are more frequent than generally appreciated and can be transient.
Occult congenital lesions, particularly in the lateral premotor and perisylvian cortices, are suggested as causes.
SPES may occur without fixed neurological deficits, contrary to prior reports.

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Startle Provoked Epileptic Seizures:features In 19 Patients