Idiopathic generalised epilepsies with typical absences in adults

Czech version

Authors: H. Krijtová; M. Tomášek; P. Marusič
Authors‘ workplace: Neurologická klinika UK 2. LF a FN Motol
Published in: Cesk Slov Neurol N 2008; 71/104(1): 34-40
Category: Review Article

Overview

The syndromes of idiopathic generalised epilepsies (IGEs) manifest with three main types of seizures – typical absences, myoclonic jerks and generalised tonic clonic seizures. Typical absence seizures are frequently underdiagnosed or misinterpreted as focal seizures in adult patients. The correct diagnosis is nevertheless of great practical significance as IGEs demand different treatment to focal epilepsies. Many neurologists still prescribe carbamazepine for typical absences with undesired results – worsening of course of epilepsy (seizures frequency, intensity or developing of absence status). Irrespective of whether all of IGE syndromes constitute a biological continuum or not, knowledge of specific features of each syndrome is required to differentiate them from focal epilepsies. This article details clinical picture of typical absences and special subtypes of absence seizures, e.g. absences with regional myoclonic jerks, and provides characteristics of different IGE syndromes with absences in adult patients.

Key words:
epilepsy - idiopathic generalised epilepsy - absence

Sources

1. Benbadis SR, Tatum WO, Gieron M. Idiopathic generalized epilepsy and choice of antiepileptic drugs. Neurology 2003; 61(12): 1793-5.

2. Panayiotopoulos CP. Idiopathic Generalised Epilepsies. In: Panayiotopoulos CP, editor. The Epilepsies: Seizures, Syndromes and Management. Chipping Norton: Bladon Medical Publishing 2005: 271-339.

3. Duron RM, Medina MT, Martinez-Juarez IE, Bailey JN, Perez-Gosiengfiao KT, Ramos-Ramirez R et al. Seizures of idiopathic generalized epilepsies. Idiopathic generalized epilepsies recognized by the International League Against Epilepsy. Use and abuse of EEG in the diagnosis of idiopathic generalized epilepsies. Epilepsia 2005; 46(Suppl 9): 34-47.

4. Nordli DR, Jr. Idiopathic generalized epilepsies recognized by the International League Against Epilepsy. Epilepsia 2005; 46(Suppl 9): 48-56.

5. Ferner RE, Panayiotopoulos CP. 'Phantom' typical absences, absence status and experiential phenomena. Seizure 1993; 2(3): 253-256.

6. Panayiotopoulos CP. Syndromes of idiopathic generalized epilepsies not recognized by the International League Against Epilepsy. Epilepsia 2005; 46(Suppl 9): 57-66.

7. Panayiotopoulos CP, Koutroumanidis M, Giannakodimos S, Agathonikou A. Idiopathic generalised epilepsy in adults manifested by phantom absences, generalised tonic-clonic seizures, and frequent absence status. J Neurol Neurosurg Psychiatry 1997; 63(5): 622-627.

8. Koutroumanidis M, Smith S. Use and abuse of EEG in the diagnosis of idiopathic generalized epilepsies. Epilepsia 2005; 46(Suppl 9): 96-107.

9. Panayiotopoulos CP. Absence epilepsies. In: Engel J, Pedley TA, editors. Epilepsy: a comprehensive textbook. Philadelphia: Lippincott-Raven 1998: 2327-2346.

10. Panayiotopoulos CP, Obeid T, Waheed G. Absences in juvenile myoclonic epilepsy: a clinical and video-electroencephalographic study. Ann Neurol 1989; 25(4): 391-397.

11. Baykan B, Noachtar S. Perioral myoclonia with absences: an overlooked and misdiagnosed generalized seizure type. Epilepsy Behav 2005; 6(3): 460-462.

12. Bilgic B, Baykan B, Gurses C, Gokyigit A. Perioral myoclonia with absence seizures: a rare epileptic syndrome. Epileptic Disord 2001; 3(1): 23-27.

13. Clemens B. Perioral myoclonia with absences? A case report with EEG and voltage mapping analysis. Brain Dev 1997; 19(5): 353-358.

14. Giannakodimos S, Panayiotopoulos CP. Eyelid myoclonia with absences in adults: a clinical and video-EEG study. Epilepsia 1996; 37(1): 36-44.

15. Mayer TA, Schroeder F, May TW, Wolf PT. Perioral reflex myoclonias: a controlled study in patients with JME and focal epilepsies. Epilepsia 2006; 47(6): 1059-1067.

16. Scuderi C, Musumeci SA, Ferri R, Calabrese G, Elia M. Eyelid myoclonia with absences in three subjects with mental retardation. Neurol Sci 2000; 21(4): 247-250.

17. Sevgi Demirci EB, Saygi S. Unusual features in eyelid myoclonia with absences: a patient with mild mental retardation and background slowing on electroencephalography. Epilepsy Behav 2006; 8(2): 442-445.