Pattern of ictal intracerebral EEG at the start of alteration of consciousness (AOC)

CAMPORA N, KOCHEN S

Congreso; 32 ND INTERNACIONAL EPILEPSY CONGRESS; 2017

Objective= The alteration of consciousness (AOC) during seizures is one of the most striking features in patients with focal epilepsy and the subjacent mechanisms are incompletely known. Better defining of intracerebral EEG morphological signal at seizure-onset and its propagation could improve the understanding of such mechanisms.Methodology= It was included 9 patients (45 seizures) with drug resistant epilepsy. All of them had RM and steroelectroencephalogrphy (SEEG). The SEEG were analysed independently by two reviewers blinded to clinical information, and consensus was reached after discussion. We analysed the patterns and localization of seizure onset and propagation, time of propagation, beginning of clinical seizure, beginning of AOC, degree of AOC and duration of seizure.Results= In mesial temporal epilepsy, the seizures with AOC were longer, the most commonly pattern of seizure-onset was sharp activity at ≤ 13Hz and the AOC occurred with or following the propagation of activity to contralateral hippocampus. In frontal epilepsy, the most commonly pattern of seizure-onset activity was low-voltage fast activity >13 Hz and the AOC occurred following the propagation of the activity to adjacent areas of the seizure-onset (overage 16 seconds after) without hippocampal commitmentIn insular epilepsy, the seizures with AOC were longer and affected both anterior and posterior insular electrodes, without commitment of hippocampus. The electrical beginning were sharp activity at ≤ 13Hz without consideration of degree of AOC. Conclusion= In our work, the AOC were mostly with of after the propagation of the seizure-onset activity. In mesial temporal seizures, the most of the AOC seizures were with contralateral hippocampus compromised. Meanwhile in frontal and insular seizures the AOC occurred when the area of discharged is enlarged without hippocampus compromised.Future works that apply different techniques for signal analysis are necessary to characterize functional connectivity between spatially distributed regions and pathophysiological mechanisms during AOC 300 PALABRAS SIN TITULO NI AU