Ictal Generalized EEG Attenuation (IGEA) and hypopnea in a child with occipital type 1 cortical dysplasia - Is it a biomarker for SUDEP?
An interesting association of ictal hypopnea and ictal generalized EEG attenuation (IGEA) as possible marker of sudden unexpected death in epilepsy (SUDEP) is reported. We describe a 5-years-old girl with left focal seizures with secondary generalization due to right occipital cortical dysplasia presenting with ictal hypopnea and IGEA. She had repeated episodes of the ictal apnoea in the past requiring ventilator support and intensive care unit (ICU) admission during episodes of status epilepticus. The IGEA lasted for 0.26-4.68 seconds coinciding with the ictal hypopnea during which both clinical seizure and electrical epileptic activity stopped. Review of literature showed correlation between post-ictal apnoea and post ictal generalized EEG suppression and increased risk for SUDEP. The report adds to the growing body of literature on peri-ictal apnea, about its association with IGEA might be considered as a marker for SUDEP. She is seizure free for 4 months following surgery.
Department of Clinical Neurosciences, Bangalore, Karnataka, India ; Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Ganne
G
Chaitanya
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
N Subbareddy
NS
Santosh
Department of Clinical Neurosciences, Bangalore, Karnataka, India ; Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Jayabal
J
Velmurugan
Department of Neurosurgery, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Arima
A
Arivazhagan
Department of Neuroimaging and Interventional Radiology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Rose D
RD
Bharath
Department of Neuropathology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Anita
A
Mahadevan
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Madhu
M
Nagappa
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Parayil S
PS
Bindu
Department of Neurosurgery, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Malla Bhaskara
MB
Rao
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Arun B
AB
Taly
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Parthasarathy
P
Satishchandra
Department of Neurology, National institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Sanjib
S
Sinha
Ictal hypopnea; SUDEP; ictal generalized EEG attenuation; occipital lobe epilepsy; status epilepticus; sudden unexpected death in epilepsy