Yıl: 2021 Cilt: 27 Sayı: 1 Sayfa Aralığı: 52 - 61 Metin Dili: İngilizce DOI: 10.14744/epilepsi.2020.21704 İndeks Tarihi: 05-06-2021

Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods

Öz:
Objectives: Epileptogenesis is still not clearly understood. Therefore, there is an inevitable need for research that investigates triggers for reflex seizures and neuropsychological activation (NPA) methods using electroencephalography (EEG) in different epileptic syndromes. In this regard, we aimed to examine the characteristics and frequency of triggers for reflex seizures as well as changes in the frequency of epilepti-form discharges (EDs), according to the stimulus in patients with generalized genetic epilepsy (GGE) and drug- resistant focal epilepsy (FE) by performing a comparative study with a survey and a neuropsychological EEG activation method, besides routine EEG.Methods: A detailed and structured survey questioning seizure triggers was applied to patients with FE and GGE. Afterward, the changes in EDs in juvenile myoclonic epilepsy (JME), absence epilepsy (AE), and resistant FE groups were examined using NPA methods with EEG.Results: The most frequently reported triggers in all patient groups (n=66) were sleep deprivation (68.2%), stress (65.3%), fatigue/physical stress (53%), awakening (42.4%), and light stimuli (25.8%). There was no significant difference between the JME (n=34), AE (n=16), and resistant FE (n=16) groups in terms of either the triggering or inhibition of EDs in EEG by conventional activation and NPA methods. While the triggering of EDs occurred in 24% of patients by hyperventilation and in 18.1% of patients by intermittent photic stimulation, a similar triggering rate was detected in 21.2% of patients by NPA methods. In addition, while the results of the conventional EEG activation methods were negative, a triggered ED was observed in six patients during NPA (11%). Only two patients showed an inhibition by the NPA methods. Four patients had EDs on their EEGs during the NPA methods associated with triggers reported in the questionnaire.Conclusion: In 11% of patients, while an ED was not seen in conventional methods, we observed that ED triggering occurred with the NPA methods. Planning the NPA methods for specific triggers during EEG recordings by prior questioning on the seizure triggers of the patients and applying NPA as an additional triggering method, especially for patients who do not have EDs in EEG with standard activation methods, may be beneficial in terms of the correct diagnosis.
Anahtar Kelime:

Sorgulama ve Elektroensefalografide Nöropsikolojik Aktivasyon Yöntemleri ileGenetik Jeneralize ve Fokal Epilepsilerde Refleks Tetiklenme Özellikleri

Öz:
maç: Epileptogenezin halen aydınlatılamadığı düşünüldüğünde refleks tetikleyici uyaranları inceleyen, elektroensefalografide nöropsikolo-jik aktivasyon yöntemlerini farklı epilepsi sendromlarında irdeleyen araştırmalara gerek vardır. Bu çalışmada, genetik jeneralize epilepsi ve dirençli fokal epilepsi tanısı olan olgularda standart elektroensefalografi ile birlikte nöropsikolojik elektroensefalografi aktivasyon yöntemlerini uygulayarak epileptiform deşarj sıklığının uyarana göre değişiminin incelenmesi, refleks nöbet tetiklenme özellikleri ile sıklığının anket ve ele-ktroensefalografi aracılığı ile karşılaştırmalı olarak araştırılması amaçlanmıştır.Gereç ve Yöntem:Genetik jeneralize epilepsi ve fokal epilepsi tanılı hastalara nöbet tetikleyicilerini sorgulayan ayrıntılı ve standardize bir anket uygulanmıştır. Anketler yüz yüze ve az sayıda hastada özel durumlarda telefonla yapılmıştır. Ardından jüvenil miyoklonik epilepsi, absans epilepsi ve dirençli fokal epilepsi gruplarında nöropsikolojik aktivasyon yöntemleriyle elektroensefalografide epileptiform deşarjların değişimi incelenmiştir.Bulgular:Tüm hasta grubunda (n=66) en sık bildirilen tetikleyiciler; uykusuzluk (%68.2), stres (%65.3), yorgunluk/fiziksel stres (%53), uykudan uyanma (%42.4) ve ışık uyaran (%25.8) olmuştur. Jüvenil miyoklonik epilepsi (n=34), absans epilepsi (n=16) ve dirençli fokal epilepsi (n=16) grupları arasında, standart aktivasyon ve nöropsikolojik aktivasyon yöntemleri ile elektroensefalografide görülen epileptiform deşarjların pro-voke olmaları açısından anlamlı bir fark saptanmamıştır. Hiperventilasyon ile hastaların %24’ünde, intermittant fotik stimülasyon ile %18.1’inde, nöropsikolojik aktivasyon ile %21.2’sinde epileptiform deşarjlarda provokasyon izlenmiştir. Standart aktivasyon yöntemlerinde epileptiform deşarj izlenmediği halde, nöropsikolojik aktivasyon ile epileptiform deşarjların provokasyonu 6 (%11) hastada görülmüştür. Sadece iki hastada nöropsikolojik aktivasyon ile inhibisyon izlenmiştir. Dört hastanın anketlerinde bildirdikleri tetikleyicileri ile ilişkili nöropsikolojik aktivasyon yöntemleri sırasında elektroensefalografilerde epileptiform deşarj izlenmiştir.Sonuç:Çalışmada, hastaların %11’inde konvansiyonel yöntemlerde epileptiform deşarj izlenmezken, nöropsikolojik aktivasyon yöntemleri ile epileptiform deşarj provokasyonu geliştiği saptanmıştır. Nöbet tetikleyicilerinin sorgulanarak elektroensefalografi kayıtları sırasında spe-sifik tetikleyicilere yönelik nöropsikolojik aktivasyon yöntemlerinin planlanmasının ve özellikle elektroensefalografilerde standart aktivasyon yöntemleri ile epileptiform deşarj görülmeyen hastalarda nöropsikolojik aktivasyonun ek provokasyon yöntemi olarak uygulanmasının tanı açısından fayda sağlayabileceği kanısındayız.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Ur Ozcelik E, Atakli H, Sirin N, KÖKSAL A, Baykan B (2021). Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. , 52 - 61. 10.14744/epilepsi.2020.21704
Chicago Ur Ozcelik Emel,Atakli Hayrunisa Dilek,Sirin Nermin Gorkem,KÖKSAL Ayhan,Baykan Betul Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. (2021): 52 - 61. 10.14744/epilepsi.2020.21704
MLA Ur Ozcelik Emel,Atakli Hayrunisa Dilek,Sirin Nermin Gorkem,KÖKSAL Ayhan,Baykan Betul Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. , 2021, ss.52 - 61. 10.14744/epilepsi.2020.21704
AMA Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. . 2021; 52 - 61. 10.14744/epilepsi.2020.21704
Vancouver Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. . 2021; 52 - 61. 10.14744/epilepsi.2020.21704
IEEE Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B "Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods." , ss.52 - 61, 2021. 10.14744/epilepsi.2020.21704
ISNAD Ur Ozcelik, Emel vd. "Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods". (2021), 52-61. https://doi.org/10.14744/epilepsi.2020.21704
APA Ur Ozcelik E, Atakli H, Sirin N, KÖKSAL A, Baykan B (2021). Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. Epilepsi, 27(1), 52 - 61. 10.14744/epilepsi.2020.21704
Chicago Ur Ozcelik Emel,Atakli Hayrunisa Dilek,Sirin Nermin Gorkem,KÖKSAL Ayhan,Baykan Betul Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. Epilepsi 27, no.1 (2021): 52 - 61. 10.14744/epilepsi.2020.21704
MLA Ur Ozcelik Emel,Atakli Hayrunisa Dilek,Sirin Nermin Gorkem,KÖKSAL Ayhan,Baykan Betul Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. Epilepsi, vol.27, no.1, 2021, ss.52 - 61. 10.14744/epilepsi.2020.21704
AMA Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. Epilepsi. 2021; 27(1): 52 - 61. 10.14744/epilepsi.2020.21704
Vancouver Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods. Epilepsi. 2021; 27(1): 52 - 61. 10.14744/epilepsi.2020.21704
IEEE Ur Ozcelik E,Atakli H,Sirin N,KÖKSAL A,Baykan B "Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods." Epilepsi, 27, ss.52 - 61, 2021. 10.14744/epilepsi.2020.21704
ISNAD Ur Ozcelik, Emel vd. "Reflex Triggering Properties in Genetic Generalized andFocal Epilepsies by Questioning and NeuropsychologicalElectroencephalography Activation Methods". Epilepsi 27/1 (2021), 52-61. https://doi.org/10.14744/epilepsi.2020.21704