Atividade eletrencefalográfica paroxística no primeiro ano de vida de pacientes epiléticos

Ribeiro, Rubens Moura

doi:10.1590/S0004-282X1969000300002

Resumos

Foram estudadas, do ponto de vista eletrencefalográfico, 80 crianças epiléticas com a finalidade de investigar os aspectos qualitativos e quantitativos dos elementos patológicos paroxísticos. Os resultados demonstraram que: 1) as manifestações paroxísticas focais apareceram de modo dominante nas projeções têmporo-oecipitais; 2) o sono contribuiu para a identificação de duas ou mais alterações simultâneas nos traçados eletrencefalográficos; 3) a atividade paroxística de projeção difusa ou focai, evidencia distribuição topográfica independente do tipo de crise clínica; 4) as características bioelétricas da atividade paroxística não revelam diferenças significativas quando analisadas nos diferentes tipos de crises clínicas; 5) o início focal das crises generalizadas pode ser demonstrado pelo EEG, mas estes focos são em geral inconsistentes e mutantes; 6) o caráter inconstante das manifestações focais, a ausência de descargas generalizadas síncronas e o caráter variável do fenômeno convulsivo clínico, são conseqüências da imaturidade cerebral.

The electroencephalographic findings in 80 children with convulsive disorders occurring during the first year of life were analysed in order to investigate the qualitative and quantitative aspects of paroxistic patterns. The following resuts were obtained: 1) the focal discharges were most commonly found over temporooccipital leads; 2) multiple focal discharges were more frequent recorded during sleep tracings; 3) there was no positive correlation between the site of the focus in EEG and concomitant clinical signs; 4) there was no positive correlation between bilateral or focal paroxystic activity and the types of seizures; 5) the initially focal course of a generalized seizure can be recorded on EEG, but the foci are inconstants and transients; 6) the inconstancy of focal discharges, the absence of bilateral paroxysmal pattern and the variability of convulsive phenomenon are related to the cerebral imaturity.

Atividade eletrencefalográfica paroxística no primeiro ano de vida de pacientes epiléticos

Paroxysmal electroencephalographic activity in the first year of life of epileptic patients

Rubens Moura Ribeiro

Departamento de Neurologia Faculdade de Medicina de Ribeirão Preto Ribeirão Preto, SP Brasil

RESUMO

Foram estudadas, do ponto de vista eletrencefalográfico, 80 crianças epiléticas com a finalidade de investigar os aspectos qualitativos e quantitativos dos elementos patológicos paroxísticos.

Os resultados demonstraram que: 1) as manifestações paroxísticas focais apareceram de modo dominante nas projeções têmporo-oecipitais; 2) o sono contribuiu para a identificação de duas ou mais alterações simultâneas nos traçados eletrencefalográficos; 3) a atividade paroxística de projeção difusa ou focai, evidencia distribuição topográfica independente do tipo de crise clínica; 4) as características bioelétricas da atividade paroxística não revelam diferenças significativas quando analisadas nos diferentes tipos de crises clínicas; 5) o início focal das crises generalizadas pode ser demonstrado pelo EEG, mas estes focos são em geral inconsistentes e mutantes; 6) o caráter inconstante das manifestações focais, a ausência de descargas generalizadas síncronas e o caráter variável do fenômeno convulsivo clínico, são conseqüências da imaturidade cerebral.

SUMMARY

The electroencephalographic findings in 80 children with convulsive disorders occurring during the first year of life were analysed in order to investigate the qualitative and quantitative aspects of paroxistic patterns.

The following resuts were obtained: 1) the focal discharges were most commonly found over temporooccipital leads; 2) multiple focal discharges were more frequent recorded during sleep tracings; 3) there was no positive correlation between the site of the focus in EEG and concomitant clinical signs; 4) there was no positive correlation between bilateral or focal paroxystic activity and the types of seizures; 5) the initially focal course of a generalized seizure can be recorded on EEG, but the foci are inconstants and transients; 6) the inconstancy of focal discharges, the absence of bilateral paroxysmal pattern and the variability of convulsive phenomenon are related to the cerebral imaturity.

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Departamento de Neurologia Faculdade de Medicina de Ribeirão Preto Ribeirão Preto, SP Brasil.

Nota do autor Agradecemos ao Prof. Armbrust-Figueiredo e Assistentes da Clínica Neurológica da Faculdade de Medicina de Ribeirão Preto, a orientação e apoio ao nosso trabalho.

Resumo da tese apresentada para concurso à Docência Livre de Clínica Neurológica na Faculdade de Medicina de Ribeirão Preto

1. BANCAUD, J.; BLOCH, V. & PAILLARD, J. Contribuition ŕ l'étude des potentiels évoqués chez l'homme au niveau du vertex. Rev. neurol. (Paris) 89:399, 1953.
2. BANCAUD, J.; TALAIRACH, J.; BORDAS-FERRER, M.; AUBER, J. L. & MARCHAND, H. Les accčs épileptiques au cours du sommeil de nuit (étude stéreo-électroencéphalographique). Electroenceph. clin. Neurophysiol. Suppl. 2: 255, 1965.
3. BLANC, C.; REBUFAT, M. & DREYFUS-BRISAC, C. Le problčme des localisations occipitales chez l'enfant. Rev. neurol. (Paris) 101:287, 1959.
4. BLANC, C.; NEYRAUT, M. T. & DREYFUS-BRISAC, C. Note sur les localisations temporales chez l'enfant. Rev. neurol. (Paris) 103:256, 1960
5. BRIDGE, E. M. Epilepsy and Convulsive Disorders in Children. McGraw-Hill, London, 1949.
6. DELANGE, M.; CASTAN, Ph.; CADILHAC, J. & PASSOUANT, P. Étude EEG des divers stades du sommeil de nuit chez l'enfant; considérations sur le stade IV ou d'activité onirique. Rev. neurol. (Paris) 105:176, 1961.
7. DELANGE, P.; CASTAN, Ph.; CADILHAC, J. & PASSOUANT, P. Étude du sommeil de nuit au cours d'épilepsies centrencéphaliques et temporales. Rev. neurol. (Paris) 106:106, 1962.
8. ELUL, R. Regional differences in hippocampus of cat: projection of dorsal and ventral hippocampus. Electroenceph. clin. Neurophysiol. 16:489, 1964.
9. ERICKSON, T. C. Spread of epileptic discharge; experimental study of afterdischarge induced by electrical stimulation of cerebral cortex. Arch. Neurol. Psychiat. (Chicago) 43:429, 1940.
10. FISCH, A. M.; OLIVEIRA, C. & FERNANDES, I. Contribuiçăo ao estudo da hipsarritmia. Arq. Neuro-Psiquiat. (Săo Paulo) 24:15, 1966.
11. GASTAUT, H. et. al. A proposed international classification of epileptic seizures. Epilepsia (Amsterdam) 5:297, 1964.
12. GASTAUT, H. & PINSARD, N. The electroencephalogram in children suffering from cerebral seizures. InSecond Advanced Course in Electroencephalography. Vienna Academy of Medicine, Vienna, 1965.
13. GIBBS, F. A.; GIBBS, E. L. & LENNOX, W. G. Electroencephalographic response to overventilation and its relation to age. J. Pediat. (St. Louis) 23:497, 1943.
14. GIBBS, E. L.; GILLEN, H. W. & GIBBS, F. A. Disappearance and migration of epileptic foci in childhood. Amer. J. Dis. Child. 88:596, 1954.
15. GIBBS, F. A. & GIBBS, E. L. Atlas of Electroencephalography; Methodology and Controls. ed. 2. Addison-Wesley, Cambridge, 1959.
16. GIBBS, E. L.; RICH, H. L.; FOIS, A. & GIBBS, F. A. Electroencephalographic study of mentally retarded person. Amer. J. ment. Deficiency 65:236, 1960.
17. GIBBS, F. A. & GIBBS, E. L. Atlas of Electroencephalography: Neurological and Psychiatric Disorders. Addison-Wesley, Cambridge, 1964.
18. HESS Jr., R. Sleep and sleep disturbances in the electroencephalogram. InAkert, K.; Bally, C. & Schadé, J. P.: Sleep Mechanisms. Elsevier, Amsterdam, 1965.
19. HILL, D. Epilepsy: clinical aspects. InHill, D. & Parr, G.: Electroencephalography: a Symposium on its Various Aspects. MacDonald, London, 1963.
20. KILOH, L. G. & OSSELTON, J. W. Clinical Electroencephalography. Butterworths, London, 1961.
21. LARRY, G. C. EEG of children with behavior disorders. InSecond Advanced Course in Electroencephalography. Vienna Academy of Medicine, Vienna, 1965.
22. LIVINGSTON, S. The Diagnosis and Treatment of Convulsive Disorders in Children. Charles C. Thomas, Springfield (Illinois), 1954.
23. LUNDERVOLD, A. A prognostic evaluation of clinical, electroencephalographic and roentgenographic findings in children with epilepsy. Epilepsia (Amsterdam) 5:33. 1964
24. NUFFIELD, E. J. A. Electro-clinical correlactions in childhood epilepsy. Epilepsia (Amsterdam) 2:178, 1961.
25. PAGNI, C. A.; MASPES, P. E. & CASSINARI, V. Étude stéreo-électroencéphalographique du lobe temporal dans sept cas d'épilepsie psychmotrice avec foyer EEG temporal. Rev. neurol. (Paris) 108:98, 1963.
26. PALESTINI, M.; PISANO, M.; ROSADINI, G. & ROSSI, G. F. Excitability cycle of the visual cortex during sleep and wakefulness. Electroenceph. clin. Neurophysiol. 19:276, 1965.
27. PATERSON, D. Convulsions (including epilepsy) in childhood. Arch. Dis. Childhood 26:441, 1951.
28. PENFIELD, W. & JASPER, H. Epilepsy and the Functional Anatomy of the Human Brain. Little Brown, Boston, 1954.
29. PETERSÉN, I.; OLOFSSON, O.; HAGNE, I. & SELLDÉN, U. EEG of selected healthy children. Electroenceph. clin. Neurophysiol. 19:613, 1965.
30. POND, D. A. The development of normal rhythms. InHill, D. & Parr, G.; Electroencephalography: a Symposium on its Various Aspects. MacDonald, London, 1963.
31. RALSTON, B. L. & AJMONE-MARSAN, C. Thalamic control of certain normal and abnormal cortical rhythms. Electroenceph. clin. Neurophysiol. 8:559, 1956.
32. RALSTON, B. L. Cingulate epilepsy and secondary bilateral synchrony. Electroenceph. clin. Neurophysiol. 13:591, 1961.
33. RIBEIRO, R. M. Achados eletrencefalográficos em pacientes com coriorretinite e reaçăo de Sabin-Feldman positiva. Tese, Faculdade Medicina de Ribeirăo Preto, 1963.
34. RIBEIRO, R. M. Achados eletrencefalográficos em crianças com crises convulsivas nos primeiros 12 meses de idade. Arq. Neuro-Psiquiat. (Săo Paulo) 24:185, 1986.
35. RICCI, G. B. & SCARINCI, A. Clinical correlations and evolution in epileptics: EEG foci in children. Electroenceph. clin. Neurophysiol. 15:919, 1963.
36. SAMSON, D.; DELANGE-WALTER, M. & MISČS, J. L'électroenphalogramme de l'enfant. Rev. neurol. (Paris) 108:138, 1963.
37. SAMSON-DOLLFUS, D.; FORTHOMME, J. & CAPRON, E. EEG of the human infant during sleep and wakefulness during the first year of life; normal patterns and their maturational changes; abnormal patterns and their prognostic significance. InKellaway, P. & Petersén, I.: Neurological and Electroencephalographic Correlative Studies in Infancy. Grune & Stratton, New York, 1964.
38. SCOTT, J. S. & KELLAWAY, P. Epilepsy of focal origin in childhood. Med. clin. N. Amer. 3:415, 1958.
39. SLOAN, N. & JASPER, H. H. Studies of the regulatory functions of the anterior limbic cortex. Electroenceph. clin. Neurophysiol. 2:317, 1950.
40. SMITH, J. M. & KELLAWAY, P. The natural history and clinical correlates of occipital foci in children. InKellaway, P. & Petersén, I.: Neurological and Electroencephalographic Correlative Studies in Infancy. Grune & Stratton, New York, 1964.
41. STEWART, L. F. & DREIFUSS, F. E. "Centrencephalic" seizures discharges in focal hemispheral lesions. Arch. Neurol. (Chicago) 17:60, 1967.
42. STORM VAN LEEUWEN, W. et al. Proposal for an EEG terminology by the committee of the International Federation for Electroencephalography and Clinical Neurophysiology. Electroenceph. clin. Neurophysiol. 20:293, 1966.
43. TROJABORG, W. Focal spike discharges in children: a longitudinal study. Acta pediat. Scand. Supl. 168, 1986.
44. TUKEL, K. & JASPER, H. H. The electroencephalogram in parasagittal lesions. Electroenceph. clin. Neurophysiol. 4:481, 1952.
45. WALKER, A. E. & UDVARHELYI, G. B. Dissemination of acute focal seizure in the monkey from subcortical foci. Arch. Neurol. (Chicago) 12:357, 1965.

Datas de Publicação

Publicação nesta coleção
23 Abr 2013
Data do Fascículo
Set 1969

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BANCAUD, J.; BLOCH, V. & PAILLARD, J. Contribuition ŕ l'étude des potentiels évoqués chez l'homme au niveau du vertex. Rev. neurol. (Paris) 89:399, 1953.

[2] 2. BANCAUD, J.; TALAIRACH, J.; BORDAS-FERRER, M.; AUBER, J. L. & MARCHAND, H. Les accčs épileptiques au cours du sommeil de nuit (étude stéreo-électroencéphalographique). Electroenceph. clin. Neurophysiol. Suppl. 2: 255, 1965.

[3] 3. BLANC, C.; REBUFAT, M. & DREYFUS-BRISAC, C. Le problčme des localisations occipitales chez l'enfant. Rev. neurol. (Paris) 101:287, 1959.

[4] 4. BLANC, C.; NEYRAUT, M. T. & DREYFUS-BRISAC, C. Note sur les localisations temporales chez l'enfant. Rev. neurol. (Paris) 103:256, 1960

[5] 5. BRIDGE, E. M. Epilepsy and Convulsive Disorders in Children. McGraw-Hill, London, 1949.

[6] 6. DELANGE, M.; CASTAN, Ph.; CADILHAC, J. & PASSOUANT, P. Étude EEG des divers stades du sommeil de nuit chez l'enfant; considérations sur le stade IV ou d'activité onirique. Rev. neurol. (Paris) 105:176, 1961.

[7] 7. DELANGE, P.; CASTAN, Ph.; CADILHAC, J. & PASSOUANT, P. Étude du sommeil de nuit au cours d'épilepsies centrencéphaliques et temporales. Rev. neurol. (Paris) 106:106, 1962.

[8] 8. ELUL, R. Regional differences in hippocampus of cat: projection of dorsal and ventral hippocampus. Electroenceph. clin. Neurophysiol. 16:489, 1964.

[9] 9. ERICKSON, T. C. Spread of epileptic discharge; experimental study of afterdischarge induced by electrical stimulation of cerebral cortex. Arch. Neurol. Psychiat. (Chicago) 43:429, 1940.

[10] 10. FISCH, A. M.; OLIVEIRA, C. & FERNANDES, I. Contribuiçăo ao estudo da hipsarritmia. Arq. Neuro-Psiquiat. (Săo Paulo) 24:15, 1966.

[11] 11. GASTAUT, H. et. al. A proposed international classification of epileptic seizures. Epilepsia (Amsterdam) 5:297, 1964.

[12] 12. GASTAUT, H. & PINSARD, N. The electroencephalogram in children suffering from cerebral seizures. InSecond Advanced Course in Electroencephalography. Vienna Academy of Medicine, Vienna, 1965.

[13] 13. GIBBS, F. A.; GIBBS, E. L. & LENNOX, W. G. Electroencephalographic response to overventilation and its relation to age. J. Pediat. (St. Louis) 23:497, 1943.

[14] 14. GIBBS, E. L.; GILLEN, H. W. & GIBBS, F. A. Disappearance and migration of epileptic foci in childhood. Amer. J. Dis. Child. 88:596, 1954.

[15] 15. GIBBS, F. A. & GIBBS, E. L. Atlas of Electroencephalography; Methodology and Controls. ed. 2. Addison-Wesley, Cambridge, 1959.

[16] 16. GIBBS, E. L.; RICH, H. L.; FOIS, A. & GIBBS, F. A. Electroencephalographic study of mentally retarded person. Amer. J. ment. Deficiency 65:236, 1960.

[17] 17. GIBBS, F. A. & GIBBS, E. L. Atlas of Electroencephalography: Neurological and Psychiatric Disorders. Addison-Wesley, Cambridge, 1964.

[18] 18. HESS Jr., R. Sleep and sleep disturbances in the electroencephalogram. InAkert, K.; Bally, C. & Schadé, J. P.: Sleep Mechanisms. Elsevier, Amsterdam, 1965.

[19] 19. HILL, D. Epilepsy: clinical aspects. InHill, D. & Parr, G.: Electroencephalography: a Symposium on its Various Aspects. MacDonald, London, 1963.

[20] 20. KILOH, L. G. & OSSELTON, J. W. Clinical Electroencephalography. Butterworths, London, 1961.

[21] 21. LARRY, G. C. EEG of children with behavior disorders. InSecond Advanced Course in Electroencephalography. Vienna Academy of Medicine, Vienna, 1965.

[22] 22. LIVINGSTON, S. The Diagnosis and Treatment of Convulsive Disorders in Children. Charles C. Thomas, Springfield (Illinois), 1954.

[23] 23. LUNDERVOLD, A. A prognostic evaluation of clinical, electroencephalographic and roentgenographic findings in children with epilepsy. Epilepsia (Amsterdam) 5:33. 1964

[24] 24. NUFFIELD, E. J. A. Electro-clinical correlactions in childhood epilepsy. Epilepsia (Amsterdam) 2:178, 1961.

[25] 25. PAGNI, C. A.; MASPES, P. E. & CASSINARI, V. Étude stéreo-électroencéphalographique du lobe temporal dans sept cas d'épilepsie psychmotrice avec foyer EEG temporal. Rev. neurol. (Paris) 108:98, 1963.

[26] 26. PALESTINI, M.; PISANO, M.; ROSADINI, G. & ROSSI, G. F. Excitability cycle of the visual cortex during sleep and wakefulness. Electroenceph. clin. Neurophysiol. 19:276, 1965.

[27] 27. PATERSON, D. Convulsions (including epilepsy) in childhood. Arch. Dis. Childhood 26:441, 1951.

[28] 28. PENFIELD, W. & JASPER, H. Epilepsy and the Functional Anatomy of the Human Brain. Little Brown, Boston, 1954.

[29] 29. PETERSÉN, I.; OLOFSSON, O.; HAGNE, I. & SELLDÉN, U. EEG of selected healthy children. Electroenceph. clin. Neurophysiol. 19:613, 1965.

[30] 30. POND, D. A. The development of normal rhythms. InHill, D. & Parr, G.; Electroencephalography: a Symposium on its Various Aspects. MacDonald, London, 1963.

[31] 31. RALSTON, B. L. & AJMONE-MARSAN, C. Thalamic control of certain normal and abnormal cortical rhythms. Electroenceph. clin. Neurophysiol. 8:559, 1956.

[32] 32. RALSTON, B. L. Cingulate epilepsy and secondary bilateral synchrony. Electroenceph. clin. Neurophysiol. 13:591, 1961.

[33] 33. RIBEIRO, R. M. Achados eletrencefalográficos em pacientes com coriorretinite e reaçăo de Sabin-Feldman positiva. Tese, Faculdade Medicina de Ribeirăo Preto, 1963.

[34] 34. RIBEIRO, R. M. Achados eletrencefalográficos em crianças com crises convulsivas nos primeiros 12 meses de idade. Arq. Neuro-Psiquiat. (Săo Paulo) 24:185, 1986.

[35] 35. RICCI, G. B. & SCARINCI, A. Clinical correlations and evolution in epileptics: EEG foci in children. Electroenceph. clin. Neurophysiol. 15:919, 1963.

[36] 36. SAMSON, D.; DELANGE-WALTER, M. & MISČS, J. L'électroenphalogramme de l'enfant. Rev. neurol. (Paris) 108:138, 1963.

[37] 37. SAMSON-DOLLFUS, D.; FORTHOMME, J. & CAPRON, E. EEG of the human infant during sleep and wakefulness during the first year of life; normal patterns and their maturational changes; abnormal patterns and their prognostic significance. InKellaway, P. & Petersén, I.: Neurological and Electroencephalographic Correlative Studies in Infancy. Grune & Stratton, New York, 1964.

[38] 38. SCOTT, J. S. & KELLAWAY, P. Epilepsy of focal origin in childhood. Med. clin. N. Amer. 3:415, 1958.

[39] 39. SLOAN, N. & JASPER, H. H. Studies of the regulatory functions of the anterior limbic cortex. Electroenceph. clin. Neurophysiol. 2:317, 1950.

[40] 40. SMITH, J. M. & KELLAWAY, P. The natural history and clinical correlates of occipital foci in children. InKellaway, P. & Petersén, I.: Neurological and Electroencephalographic Correlative Studies in Infancy. Grune & Stratton, New York, 1964.

[41] 41. STEWART, L. F. & DREIFUSS, F. E. "Centrencephalic" seizures discharges in focal hemispheral lesions. Arch. Neurol. (Chicago) 17:60, 1967.

[42] 42. STORM VAN LEEUWEN, W. et al. Proposal for an EEG terminology by the committee of the International Federation for Electroencephalography and Clinical Neurophysiology. Electroenceph. clin. Neurophysiol. 20:293, 1966.

[43] 43. TROJABORG, W. Focal spike discharges in children: a longitudinal study. Acta pediat. Scand. Supl. 168, 1986.

[44] 44. TUKEL, K. & JASPER, H. H. The electroencephalogram in parasagittal lesions. Electroenceph. clin. Neurophysiol. 4:481, 1952.

[45] 45. WALKER, A. E. & UDVARHELYI, G. B. Dissemination of acute focal seizure in the monkey from subcortical foci. Arch. Neurol. (Chicago) 12:357, 1965.