Absence-to-bilateral-tonic-clonic seizure: A generalized seizure type.

Authors

Sándor Beniczky, Aarhus University, University of Copenhagen, IRCCS Institute of Neurological Science, Bellaria Hospital, Children's Hospital "Agia Sophia," and Thomas Jefferson University
Guido Rubboli, Aarhus University, University of Copenhagen, IRCCS Institute of Neurological Science, Bellaria Hospital, Children's Hospital "Agia Sophia," and Thomas Jefferson University
Athanasios Covanis, Aarhus University, University of Copenhagen, IRCCS Institute of Neurological Science, Bellaria Hospital, Children's Hospital "Agia Sophia," and Thomas Jefferson University
Michael R Sperling, Aarhus University, University of Copenhagen, IRCCS Institute of Neurological Science, Bellaria Hospital, Children's Hospital "Agia Sophia," and Thomas Jefferson University

Document Type

Article

Publication Date

10-6-2020

Comments

This is the final published copy of the article from the journal Neurology, 2020, Oct 6;95(14):e2009-e2015.

The article can also be found at: http://doi.org/10.1212/WNL.0000000000010470

Copyright, The Authors.

Abstract

OBJECTIVE: To test the hypothesis that absence seizures can evolve to generalized tonic-clonic seizures, we documented electroclinical features of this novel seizure type.

METHODS: In 4 large video-EEG databases, we identified recordings of seizures starting with impaired awareness that, without returning to baseline interictal state, evolved to generalized tonic-clonic seizures. We extracted the detailed semiologic and electrographic characteristics of these seizures, and we documented the clinical background, diagnoses, and therapeutic responses in these patients.

RESULTS: We identified 12 seizures from 12 patients. All seizures started with a period of impaired awareness and bursts of generalized spike or polyspike and slow-wave discharges, the hallmark of absence seizures. Without returning to baseline, the nonmotor (absence) phase was followed by tonic-clonic convulsions. We called this novel generalized seizure type absence-to-bilateral-tonic-clonic seizure. Most patients had idiopathic generalized epilepsies, although with a high incidence of unusual features and poor therapeutic response.

CONCLUSIONS: Absence-to-bilateral-tonic-clonic seizures are a novel generalized seizure type. Clinicians should be aware of this seizure for correctly diagnosing patients. This novel seizure type may further elucidate generalized ictogenesis.

Recommended Citation

Beniczky, Sándor; Rubboli, Guido; Covanis, Athanasios; and Sperling, Michael R, "Absence-to-bilateral-tonic-clonic seizure: A generalized seizure type." (2020). Department of Neurology Faculty Papers. Paper 223.
https://jdc.jefferson.edu/neurologyfp/223

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

32817392

Language

English