title: Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua: a European survey and analysis of 65 cases.
abstract: OBJECTIVE
  To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation.
  
  
  METHODS
  In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥ 1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded.
  
  
  RESULTS
  Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies.
  
  
  CONCLUSIONS
  The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
authors.affiliation: Department of Neurology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania Epilepsy Centre Kork, Kehl-Kork, Germany. ruta.mameniskiene@santa.lt
authors.forename: Ruta
authors.initials: R
authors.lastname: Mameniskiene
authors.forename: Thomas
authors.initials: T
authors.lastname: Bast
authors.forename: Carla
authors.initials: C
authors.lastname: Bentes
authors.forename: Maria P
authors.initials: MP
authors.lastname: Canevini
authors.forename: Petia
authors.initials: P
authors.lastname: Dimova
authors.forename: Tiziana
authors.initials: T
authors.lastname: Granata
authors.forename: Hans
authors.initials: H
authors.lastname: Høgenhaven
authors.forename: Bosanka Jocic
authors.initials: BJ
authors.lastname: Jakubi
authors.forename: Petr
authors.initials: P
authors.lastname: Marusic
authors.forename: Gayane
authors.initials: G
authors.lastname: Melikyan
authors.forename: Roberto
authors.initials: R
authors.lastname: Michelucci
authors.forename: Konstantin Y
authors.initials: KY
authors.lastname: Mukhin
authors.forename: Bernhard
authors.initials: B
authors.lastname: Oehl
authors.forename: Francesca
authors.initials: F
authors.lastname: Ragona
authors.forename: Andrea O
authors.initials: AO
authors.lastname: Rossetti
authors.forename: Guido
authors.initials: G
authors.lastname: Rubboli
authors.forename: Susanne
authors.initials: S
authors.lastname: Schubert
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stephani
authors.forename: Julia
authors.initials: J
authors.lastname: Strobel
authors.forename: Aglaia
authors.initials: A
authors.lastname: Vignoli
authors.forename: Jana
authors.initials: J
authors.lastname: Zarubova
authors.forename: Peter
authors.initials: P
authors.lastname: Wolf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003625:Data Collection / Q000379:methods; D004660:Encephalitis; D017036:Epilepsia Partialis Continua / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D020521:Stroke; D055815:Young Adult