[en] [en] OBJECTIVE: Evaluate the prevalence of epileptic seizures (ES) and epileptiform discharges (EDs) in patients with prolonged disorders of consciousness (DOC), and potential influence of amantadine on epilepsy.
METHODS: We conducted a retrospective study in 34 patients hospitalized in a DOC care unit for prolonged DOC between 2012 and 2018, who received a long-term EEG monitoring (LTM). We reviewed the prevalence of ES, EDs and nonconvulsive seizures (NCSz), the type of DOC recovery treatment administered, and neurological outcome.
RESULTS: LTM was more effective than standard EEGs in detecting EDs (32% vs 21% respectively). Moreover, 12% of the LTM showed NCSz. Among patients with EDs in LTM, 73% showed no EDs in standard EEG recordings, even when performed more than once. The presence of EDs and/or NCSz in LTM was significantly associated with the occurrence of remote clinical epileptic seizures (p = 0.017) but did not influence neurological outcome (p = 1). Amantadine was not associated with higher occurrence of EDs/NCSz or clinical seizures.
CONCLUSION: In our prolonged DOC population, LTM showed more pathological results (EDs and NCSz) than standard EEGs, which was significantly associated with remote clinical seizures.
SIGNIFICANCE: The use of LTM might be advised to rule out NCSz in patients with prolonged DOC.
Disciplines :
Neurology
Author, co-author :
Fierain, A; William Lennox Neurological Hospital (WLNH), Ottignies, Belgium, Refractory Epilepsy Reference Center, Université Catholique de Louvain (UCLouvain) - Saint-Luc University Hospital, Belgium. Electronic address: fierain.alexane@gmail.com
Gaspard, N; Neurology Department and Refractory Epilepsy Reference Center, Université Libre de Bruxelles (ULB) - Erasme University Hospital, Brussels, Belgium, Department of Neurology - Yale University School of Medicine, New Haven, CT, USA
Lejeune, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
El Tahry, R; Refractory Epilepsy Reference Center, Université Catholique de Louvain (UCLouvain) - Saint-Luc University Hospital, Belgium, Institute of Neuroscience (IoNS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
Speybroeck, N; Institute of Health and Society (IRSS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
Dermauw, V; Institute of Tropical Medicine, Antwerp, Belgium
Ferrao Santos, S; William Lennox Neurological Hospital (WLNH), Ottignies, Belgium, Refractory Epilepsy Reference Center, Université Catholique de Louvain (UCLouvain) - Saint-Luc University Hospital, Belgium, Institute of Neuroscience (IoNS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
Language :
English
Title :
Beware of nonconvulsive seizures in prolonged disorders of consciousness: Long-term EEG monitoring is the key.
NL is a post-doctoral researcher of the F.N.R.S.-Fonds National pour la Recherche Scientifique (FNRS), Belgium. AF received a grant from the Fondation Saint Luc .NL is a post-doctoral researcher of the F.N.R.S.-Fonds National pour la Recherche Scientifique (FNRS), Belgium. AF received a grant from the Fondation Saint Luc.
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