title: Reflex seizures in patients with malformations of cortical development and refractory epilepsy.
abstract: OBJECTIVE
  Malformations of cortical development (MCDs) are usually highly epileptogenic, and their hyperexcitability could facilitate the occurrence of reflex seizures. We sought to characterize reflex seizures in patients with MCDs and refractory epilepsy.
  
  
  METHODS
  Clinical, electrographic, and neuroimaging data were reviewed in eight patients with MCDs who had reflex seizures reproduced during presurgical evaluation.
  
  
  RESULTS
  All eight patients had both reflex and spontaneous seizures. In six, however, drop attacks or axial myoclonic seizures occurred only upon specific sensory stimulation. Reflex seizures were induced by more than one type of stimulus in most patients, but anatomofunctional correlations could usually be invoked. Six patients had significant intellectual impairment. Surgical resection controlled seizures in two patients.
  
  
  CONCLUSIONS
  Reflex seizures in patients with MCDs may be medically refractory and may often manifest as drop attacks or axial myoclonus. Surgical resection of focal lesions can bring reflex seizures under control. Putative mechanisms related to the relatively low frequency of reflex seizures in MCDs are discussed.
authors.affiliation: Porto Alegre Epilepsy Surgery Program, Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil. apalmini@uol.com.br
authors.forename: André
authors.initials: A
authors.lastname: Palmini
authors.forename: Peter
authors.initials: P
authors.lastname: Halasz
authors.forename: Ingrid E
authors.initials: IE
authors.lastname: Scheffer
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Angeles Perez
authors.initials: AP
authors.lastname: Jimenez
authors.forename: François
authors.initials: F
authors.lastname: Dubeau
authors.forename: Frederick
authors.initials: F
authors.lastname: Andermann
authors.forename: Eliseu
authors.initials: E
authors.lastname: Paglioli-Neto
authors.forename: Jaderson Costa
authors.initials: JC
authors.lastname: da Costa
authors.forename: Felix
authors.initials: F
authors.lastname: Rosenow
authors.forename: Brita
authors.initials: B
authors.lastname: Fritsch
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography / Q000706:statistics & numerical data; D004831:Epilepsies, Myoclonic / Q000453:epidemiology / Q000503:physiopathology; D004827:Epilepsy / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D020195:Epilepsy, Reflex / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000502:physiology; D011300:Preoperative Care
chemical_list: D018377:Neurotransmitter Agents