Epilepsia com pontas centrotemporais e com pontas parietais: estudo comparativo

Fonseca, Lineu Corrêa; Tedrus, Gloria M.A.

doi:10.1590/S0004-282X1995000200004

Resumos

Há controvérsias sobre a existência de uma epilepsia parcial benigna parietal distinta da epilepsia com pontas rolândicas. Estudamos 164 crianças com epilepsia e focos restritos às regiões centrais, temporais médias e parietais, sendo excluídas as que apresentavam elementos indicativos de lesão cerebral. Foram analisados a idade dos pacientes, a idade de início, o tipo e o número das crises, antecedentes familiares para epilepsia e a reatividade à percussão dos pés e mãos ao EEC As pontas foram de localização central e/ou temporal média (PCT) em 111 casos (temporal média em 56, centrotemporal em 29, central em 26) e parietal (PP) em 53 casos. A idade dos pacientes e idade de início das crises predominaram na faixa até 6 anos de idade no grupo com PP e acima dos 6 anos no grupo com PCT. As crises orofaríngeas e motoras da face corresponderam a 44,1% das crianças com PCT e, apenas, a 16,9% daquelas com PP. Pontas evocadas por estímulos somatossensoriais, ao EEG, foram registradas em proporção mais elevada de casos com PP (39,5%) do que no grupo com PCT (3,5%). Nossos achados mostram que epilepsia, na ausência de sinais lesionais, em crianças com PP, é relativamente frequente e tanto a idade dos pacientes, idade de início e perfil das crises, quanto a reatividade do EEG à percussão de pés e mãos, mostram diferenças significativas em relação ao observado nas crianças com PCT.

infância; eletrencefalografia; epilepsia parcial benigna; pontas evocadas

There are controversies about the existence of a benign parietal epilepsy distinct from the benign partial epilepsy with centro-temporal spikes. We studied 164 children with no neurological or neuroradiological evidence of brain damage and with epilepsy and spikes restricted to the centro-temporal (CTS) or to the parietal regions (PS). The subject's age, age at onset and type of seizures and the presence of spikes evoked by consecutive taps applied to both hands and feet were compared between 111 patients with CTS and 53 patients with PS. Age of patients and age at onset of seizures predominated until 6 years in the PS group and after 6 years in the CTS group. The occurrence of oropharyngeal or facial motor seizures was statistically more frequent among the patients with CTS (44.1%) as opposed to PS group (16.9%). In 39.5% of the children with PS and only in 3.5% of those with CTS, the EEG showed high voltage potentials, similar to the habitual spikes in clinical EEG, evoked by the stimulation of one or both feet or hands. Our findings suggest that in neurologically normal children with epilepsy, the group with PS differs from those with CTS in the age, age at onset and type of seizures and EEG reactivity to percussion of hands and feet.

childhood; electroencephalography; benign partial epilepsy; evoked spikes

Epilepsia com pontas centrotemporais e com pontas parietais: estudo comparativo

A comparative study of children with epilepsy and centro-temporal spikes or parietal spikes

Lineu Corrêa Fonseca^I; Gloria M.A. Tedrus^II

^IProfessor Titular

^IIProfessora Assistente

RESUMO

Há controvérsias sobre a existência de uma epilepsia parcial benigna parietal distinta da epilepsia com pontas rolândicas. Estudamos 164 crianças com epilepsia e focos restritos às regiões centrais, temporais médias e parietais, sendo excluídas as que apresentavam elementos indicativos de lesão cerebral. Foram analisados a idade dos pacientes, a idade de início, o tipo e o número das crises, antecedentes familiares para epilepsia e a reatividade à percussão dos pés e mãos ao EEC As pontas foram de localização central e/ou temporal média (PCT) em 111 casos (temporal média em 56, centrotemporal em 29, central em 26) e parietal (PP) em 53 casos. A idade dos pacientes e idade de início das crises predominaram na faixa até 6 anos de idade no grupo com PP e acima dos 6 anos no grupo com PCT. As crises orofaríngeas e motoras da face corresponderam a 44,1% das crianças com PCT e, apenas, a 16,9% daquelas com PP. Pontas evocadas por estímulos somatossensoriais, ao EEG, foram registradas em proporção mais elevada de casos com PP (39,5%) do que no grupo com PCT (3,5%). Nossos achados mostram que epilepsia, na ausência de sinais lesionais, em crianças com PP, é relativamente frequente e tanto a idade dos pacientes, idade de início e perfil das crises, quanto a reatividade do EEG à percussão de pés e mãos, mostram diferenças significativas em relação ao observado nas crianças com PCT.

Palavras-chave: infância, eletrencefalografia, epilepsia parcial benigna, pontas evocadas.

SUMMARY

There are controversies about the existence of a benign parietal epilepsy distinct from the benign partial epilepsy with centro-temporal spikes. We studied 164 children with no neurological or neuroradiological evidence of brain damage and with epilepsy and spikes restricted to the centro-temporal (CTS) or to the parietal regions (PS). The subject's age, age at onset and type of seizures and the presence of spikes evoked by consecutive taps applied to both hands and feet were compared between 111 patients with CTS and 53 patients with PS. Age of patients and age at onset of seizures predominated until 6 years in the PS group and after 6 years in the CTS group. The occurrence of oropharyngeal or facial motor seizures was statistically more frequent among the patients with CTS (44.1%) as opposed to PS group (16.9%). In 39.5% of the children with PS and only in 3.5% of those with CTS, the EEG showed high voltage potentials, similar to the habitual spikes in clinical EEG, evoked by the stimulation of one or both feet or hands. Our findings suggest that in neurologically normal children with epilepsy, the group with PS differs from those with CTS in the age, age at onset and type of seizures and EEG reactivity to percussion of hands and feet.

Key words: childhood, electroencephalography, benign partial epilepsy, evoked spikes.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 2-outubro-1994.

Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas

Dr. Lineu Corrêa Fonseca - Rua Sebastião de Souza 205 cj 122 - 13020-020 Campinas SP - Brasil.

1. Aicardi J. Epileptic syndromes in childhood. Epilepsia 1988, 29 (Suppl 3):1-5.
2. Beaussart M. Benign epilepsy of children with rolandic (centro-temporal) paroxysmal foci. Epilepsia 1972, 13:795-801.
3. Blom S, Heijbel J, Bergfors PG. Benign epilepsy of children with centro-temporal EEG foci: prevalence and follow-up of 40 patients. Epilepsia 1972, 13:609-619.
4. Blom S, Heijbel J. Benign epilepsy of children with centro-temporal EEG foci: a follow-up study in adulthood of patients initially studied as children. Epilepsia 1982, 23:629-632.
5. Commission on Classification and Terminology of the International League against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes.Epilepsia 1989, 30: 389-399.
6. DeMarco P. Evoked parietal spikes and childhood epilepsy. Arch Neurol 1980, 37:291-292.
7. Drury I, Beydoun A. Benign partial epilepsy of childhood with monomorphic sharp waves in centrotemporal and other locations. Epilepsia 1991, 32:662-667.
8. Fonseca LC, Tedrus GMA. Pontas parietais evocadas ao eletrencefalograma e convulsőes febris. Arq Neuropsiquiatr 1988, 46:127-132.
9. Fonseca LC, Tedrus GMA. Epileptic syndromes in children with somatosensory evoked spikes. Clin Electroenceph 1994, 25:54-58.
10. Gibbs EL, Gillen HW, Gibbs FA. Disappearance and migration of epileptic foci in childhood. Am J Dis Child 1954, 88:596-603.
11. Gregory DL, Wong PK. Topographical analysis of the centro-temporal discharges in benign rolandic epilepsy of childhood. Epilepsia 1984, 25:705-711.
12. Gregory DL, Wong PKH. Clinical relevance of a dipole field in rolandic spikes. Epilepsia 1992, 33:36-44.
13. Lerman P, Kivity-Ephraim S. Benign focal epilepsy of childhood: a follw up study of 100 recovered patients. Arch Neurol 1975, 32:261-264.
14. Loiseau P, Beaussart M. The seizures of benign childhood epilepsy with rolandic paroxysmal discharges. Epilepsia 1973, 14:381-389.
15. Lombroso CT. Sylvian seizures and mid-temporal spike foci in children. Arch Neurol 1967, 17:52-59.
16. Nayrac MMP, Beaussart M. Les pointes-ondes prerolandiques: expression EEG trés particuličre. Étude électroclinique de 21 cas. Rev Neurol 1957, 17:52-59.

Datas de Publicação

Publicação nesta coleção
20 Jan 2011
Data do Fascículo
Jun 1995

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

[1] 1. Aicardi J. Epileptic syndromes in childhood. Epilepsia 1988, 29 (Suppl 3):1-5.

[2] 2. Beaussart M. Benign epilepsy of children with rolandic (centro-temporal) paroxysmal foci. Epilepsia 1972, 13:795-801.

[3] 3. Blom S, Heijbel J, Bergfors PG. Benign epilepsy of children with centro-temporal EEG foci: prevalence and follow-up of 40 patients. Epilepsia 1972, 13:609-619.

[4] 4. Blom S, Heijbel J. Benign epilepsy of children with centro-temporal EEG foci: a follow-up study in adulthood of patients initially studied as children. Epilepsia 1982, 23:629-632.

[5] 5. Commission on Classification and Terminology of the International League against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes.Epilepsia 1989, 30: 389-399.

[6] 6. DeMarco P. Evoked parietal spikes and childhood epilepsy. Arch Neurol 1980, 37:291-292.

[7] 7. Drury I, Beydoun A. Benign partial epilepsy of childhood with monomorphic sharp waves in centrotemporal and other locations. Epilepsia 1991, 32:662-667.

[8] 8. Fonseca LC, Tedrus GMA. Pontas parietais evocadas ao eletrencefalograma e convulsőes febris. Arq Neuropsiquiatr 1988, 46:127-132.

[9] 9. Fonseca LC, Tedrus GMA. Epileptic syndromes in children with somatosensory evoked spikes. Clin Electroenceph 1994, 25:54-58.

[10] 10. Gibbs EL, Gillen HW, Gibbs FA. Disappearance and migration of epileptic foci in childhood. Am J Dis Child 1954, 88:596-603.

[11] 11. Gregory DL, Wong PK. Topographical analysis of the centro-temporal discharges in benign rolandic epilepsy of childhood. Epilepsia 1984, 25:705-711.

[12] 12. Gregory DL, Wong PKH. Clinical relevance of a dipole field in rolandic spikes. Epilepsia 1992, 33:36-44.

[13] 13. Lerman P, Kivity-Ephraim S. Benign focal epilepsy of childhood: a follw up study of 100 recovered patients. Arch Neurol 1975, 32:261-264.

[14] 14. Loiseau P, Beaussart M. The seizures of benign childhood epilepsy with rolandic paroxysmal discharges. Epilepsia 1973, 14:381-389.

[15] 15. Lombroso CT. Sylvian seizures and mid-temporal spike foci in children. Arch Neurol 1967, 17:52-59.

[16] 16. Nayrac MMP, Beaussart M. Les pointes-ondes prerolandiques: expression EEG trés particuličre. Étude électroclinique de 21 cas. Rev Neurol 1957, 17:52-59.