Risk factors of postictal generalized EEG suppression in generalized convulsive seizures.

  • Veriano Alexandre
  • Blanca Mercedes
  • Luc Valton
  • Louis Maillard
  • Fabrice Bartolomei
  • William Szurhaj
  • Edouard Hirsch
  • Cécile Marchal
  • Francine Chassoux
  • Jérôme Petit
  • Arielle Crespel
  • Anca Nica
  • Vincent Navarro
  • Philippe Kahane
  • Bertrand De Toffol
  • Pierre Thomas
  • Sarah Dominique Rosenberg
  • Marie Denuelle
  • Jacques Jonas
  • Philippe Ryvlin
  • Sylvain Rheims
  • Cécile Marchal
  • Dominique Sarah Rosenberg
  • Philippe Kahane
  • Lorella Minotti
  • Laurent Vercueil
  • Cécile Sabourdy
  • Jérome Petit
  • Didier Tourniaire
  • Vieira Eid
  • Philippe Derambure
  • William Szurhaj
  • Louise Tyvaert
  • Philippe Ryvlin
  • Sylvain Rheims
  • Jean Isnard
  • Helène Catenoix
  • Fabrice Bartolomei
  • Agnes Trebuchon
  • Aileen Mc Gonigal
  • Sandrine Aubert
  • Arielle Crespel
  • Philippe Gelisse
  • Louis Maillard
  • Jean-Pierre Vignal
  • Jacques Jonas
  • Pierre Thomas
  • Véronique Bourg
  • Francine Chassoux
  • Elisabeth Landre
  • Vincent Navarro
  • Sophie Dupont
  • Claude Adam
  • Arnaud Biraben
  • Anca Nica
  • Edouard Hirsch
  • Maria-Paolo Valenti
  • Julia Scholly
  • Luc Valton
  • Marie Denuelle
  • Bertrand De Toffol

Source: Neurology

Publié le

Résumé

OBJECTIVE: To identify the clinical determinants of occurrence of postictal generalized EEG suppression (PGES) after generalized convulsive seizures (GCS).

METHODS: We reviewed the video-EEG recordings of 417 patients included in the REPO2MSE study, a multicenter prospective cohort study of patients with drug-resistant focal epilepsy. According to ictal semiology, we classified GCS into 3 types: tonic-clonic GCS with bilateral and symmetric tonic arm extension (type 1), clonic GCS without tonic arm extension or flexion (type 2), and GCS with unilateral or asymmetric tonic arm extension or flexion (type 3). Association between PGES and person-specific or seizure-specific variables was analyzed after correction for individual effects and the varying number of seizures.

RESULTS: A total of 99 GCS in 69 patients were included. Occurrence of PGES was independently associated with GCS type (p < 0.001) and lack of early administration of oxygen (p < 0.001). Odds ratio (OR) for GCS type 1 in comparison with GCS type 2 was 66.0 (95% confidence interval [CI 5.4-801.6]). In GCS type 1, risk of PGES was significantly increased when the seizure occurred during sleep (OR 5.0, 95% CI 1.2-20.9) and when oxygen was not administered early (OR 13.4, 95% CI 3.2-55.9).

CONCLUSION: The risk of PGES dramatically varied as a function of GCS semiologic characteristics. Whatever the type of GCS, occurrence of PGES was prevented by early administration of oxygen.