Can epileptologists without access to intracranial EEG use reliably the International League Against Epilepsy classification of the localization-related epileptic syndromes? A stereo-electroencephalographic study.

The goal of the present study was to investigate the reliability of clinical and electroencephalographic (EEG) criteria for the classification of localization-related epileptic syndromes as listed in the Proposals of Revised Classification of Epilepsies and Epileptic Syndromes 1989 (ICE). ICE distinguishes between multiple syndromes within epilepsies of a given lobe. Intracranial recordings were the main element in the development of the revised ICE.

Anatomical origin of déjà vu and vivid 'memories' in human temporal lobe epilepsy.

Jackson (Brain 1898; 21: 580-90) observed that seizures arising in the medial temporal lobe may result in a 'dreamy state', consisting of vivid memory-like hallucinations, and/or the sense of having previously lived through exactly the same situation (déjà vu). Penfield demonstrated that the dreamy state can sometimes be evoked by electrical stimulation of the lateral temporal neocortex, especially the superior temporal gyrus. Halgren et al.

Pathological left-handedness. Left-handedness correlatives in adult epileptics.

Factors associated with left-handedness were examined in a large sample of adults who suffered with epileptic seizures (n = 446) in an attempt to delineate the concept of pathological left-handedness. Three main pathological factors were found associated with left-handedness: (i) right-hemiparesis of early onset; (ii) cognitive deficit; (iii) evidence of left-hemisphere disease on clinical examination. Familial sinistrality was also associated with left-handedness, independently of the above-mentioned pathological factors.

Surgical therapy for frontal epilepsies.

We have described our 25 years experience concerning 100 patients operated on for frontal epilepsy. Results show that 55% of patients are practically cured of their seizures and that 76% benefited from cortectomy (reduction of more than 75% of seizures). These results are the worst in the total series of St.

Evidence for a contribution of the auditory cortex to audiospinal facilitation in man.

Facilitation of the spinal monosynaptic reflex by auditory stimulation has been demonstrated previously in animals and man. Analysis of the time course of audiospinal facilitation (ASF) in normal subjects is reported. The role of the cerebral cortex in the control of audiospinal facilitation was investigated in 32 patients with anatomically well-circumscribed lesions, the precise topography of which was determined stereotaxically.

Stereotactic investigations in frontal lobe epilepsies.

The aim of a Stereo-EEG investigation is to verify and prove that the hypothesis, done on the basis of the preliminary investigations (clinical, EEG, neuroradiological), are correct. This task is particularly hard in frontal lobe epilepsies, because of anatomical and physiopathological reasons. Among 277 consecutive patients, 86 were explored for a probable frontal epilepsy.

[Early right posterior cerebral hemispheric lesion and right speech dominance in 2 right-handed female patients].

Two female patients presented a severe partial epilepsy of early onset and an extended right posterior hemispheric lesion of prenatal or perinatal origin. They were right-handed and all their first degree relatives were right-handed. Nevertheless, evidence of right hemispheric speech was documented in both patients, on the basis of a bilateral sodium amytal test in one case, and of a persistent aphasia after neurosurgical treatment in the other.

Hemispheric lateralization of motor and speech functions after early brain lesion: study of 73 epileptic patients with intracarotid amytal test.

This study reports results of a bilateral intracarotid amytal test in 73 epileptic patients with medically intractable focal seizures. No right-handers but 50% of left-handers have a right dominance for speech in this particular population. Lateralization of cerebral speech functions, as well as manual preference, are dependent on the neurological disease and can shift conjointly or independently.

Gustatory hallucinations in epileptic seizures. Electrophysiological, clinical and anatomical correlates.

Of the 718 patients investigated for intractable epilepsy by stereoelectrocencephalographic (SEEG) exploration, 30 (4%) manifested gustatory hallucinations as part of their seizures. In 20 patients, it was possible to make some electrophysiological, clinical and anatomical correlates. Gustatory hallucinations occurred as one manifestation of parietal, temporal or temporoparietal seizures.

[The "epileptogenic zone" in humans: representation of intercritical events by spatio-temporal maps].

In the preoperative investigation of partial epilepsies, electrical characteristics of the so-called epileptogenic area are of critical interest to localize this area. We have always emphasized that the analysis of ictal events themselves, is more valuable than that of inter-ictal anomalis. One reason for this emphasis has been the absence of a reliable method to evaluate the relationship between the topography of ictal and interictal events.

[Clinical symptomatology of epileptic seizures of temporal origin].

Many discrepancies still exist in the description of clinical symptoms and signs attributable to a paroxysmal disorganization of temporal structures. They result from various methodological appraisals of clinical, electrophysiological and neuroradiological data concerning partial epilepsies. However a study of anatomo-electroclinical correlations in temporal seizures yield an easy pattern when the methods of elaboration, the criteria of validity and their meaning are strictly defined.

Distinction between the myoclonus-related potential and the epileptic spike in epilepsia partialis continua.

Neurophysiological analysis of spontaneous and reflex-triggered myoclonus in a case of epilepsia partialis continua is reported. A central positive wave (P1), part of the high voltage evoked potential and of the spontaneous spike, is held to be responsible for the myoclonic jerk. It is demonstrated that P1 is a distinct phenomenon from both the evoked potential and the epileptic spike, and so should be identified as a myoclonus-related potential (MRP).

[Electro-clinical semiology of subintrant temporal lobe seizures].

The authors recorded 10 to 67 TLS (mean 29) in 10 patients (5 M, 5 F; 9 to 41 years, mean 23) during 'acute' (4-6 hours) stereo-EEG exploration. At the onset of seizures, we observed: subjective manifestations (often epigastric), autonomic symptoms, and oro-alimentary 'automatisms'. Affective, unpleasant, manifestations occurred in only 2 patients.