Reflex seizures in patients with malformations of cortical development and refractory epilepsy.
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.
Palmini
André
A
Porto Alegre Epilepsy Surgery Program, Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil. apalmini@uol.com.br
Halasz
Peter
P
Scheffer
Ingrid E
IE
Takahashi
Yukitoshi
Y
Jimenez
Angeles Perez
AP
Dubeau
François
F
Andermann
Frederick
F
Paglioli-Neto
Eliseu
E
da Costa
Jaderson Costa
JC
Rosenow
Felix
F
Fritsch
Brita
B
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
D018377:Neurotransmitter Agents