Risk factors of postictal generalized EEG suppression in generalized convulsive seizures

Veriano Alexandre¹, Blanca Mercedes¹, Luc Valton¹, Louis Maillard¹, Fabrice Bartolomei¹, William Szurhaj¹, Edouard Hirsch¹, Cécile Marchal¹, Francine Chassoux¹, Jérôme Petit¹, Arielle Crespel¹, Anca Nica¹, Vincent Navarro¹, Philippe Kahane¹, Bertrand De Toffol¹, Pierre Thomas¹, Sarah Rosenberg¹, Marie Denuelle¹, Jacques Jonas¹, Philippe Ryvlin¹, Sylvain Rheims²; REPO2MSE study group

Collaborators, Affiliations

Collaborators

REPO2MSE study group:
Cécile Marchal, Dominique Sarah Rosenberg, Philippe Kahane, Lorella Minotti, Laurent Vercueil, Cécile Sabourdy, Jérome Petit, Didier Tourniaire, Vieira Eid, Philippe Derambure, William Szurhaj, Louise Tyvaert, Philippe Ryvlin, Sylvain Rheims, Jean Isnard, Helène Catenoix, Fabrice Bartolomei, Agnes Trebuchon, Aileen Mc Gonigal, Sandrine Aubert, Arielle Crespel, Philippe Gelisse, Louis Maillard, Jean-Pierre Vignal, Jacques Jonas, Pierre Thomas, Véronique Bourg, Francine Chassoux, Elisabeth Landre, Vincent Navarro, Sophie Dupont, Claude Adam, Arnaud Biraben, Anca Nica, Edouard Hirsch, Maria-Paolo Valenti, Julia Scholly, Luc Valton, Marie Denuelle, Bertrand De Toffol

Affiliations

¹ From the Department of Functional Neurology and Epileptology (V.A., B.M., S.R.) and the Institute of Epilepsies (E.H., P.R., S.R.), Hospices Civils de Lyon and Lyon 1 University; Lyon's Neuroscience Research Center (V.A., B.M., P.R., S.R.), INSERM U1028/CNRS UMR 5292, Lyon, France; the Hospital of Clinics of Ribeirão Preto (V.A.), University of São Paulo, Brazil; the Department of Neurology (L.V., M.D.), University Hospital of Toulouse; the Neurology Department (L.M., J.J.), University Hospital of Nancy; the Clinical Neurophysiology and Epileptology Department (F.B.), Timone Hospital, Marseille; the Department of Clinical Neurophysiology (W.S.), Lille University Medical Center, EA 1046, University of Lille2; the Department of Neurology (E.H.), University Hospital of Strasbourg; the Department of Neurology (C.M.), Hôpital Pellegrin, Bordeaux; the Epilepsy Unit (F.C.), Department of Neurosurgery, Centre Hospitalier Sainte-Anne; University Paris Descartes; La Teppe Epilepsy Center (J.P.), Tain l'Hermitage; the Epilepsy Unit (A.C.), Montpellier; the Department of Neurology (A.N.), University Hospital of Rennes; the Epileptology Unit (V.N.), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière and Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC University Paris 06), Paris; the Department of Neurology (P.K.), Michallon Hospital, GIN, INSERM U836, UJF, Grenoble Alpes University, Grenoble; the Department of Clinical Neurophysiology (B.D.T.), INSERM U930, University Hospital of Tours; the Department of Neurology (P.T.), University Hospital of Nice; the Department of Neurology (S.R.), University Hospital of Clermont-Ferrand, France; and the Department of Clinical Neurosciences (P.R.), Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland.
² From the Department of Functional Neurology and Epileptology (V.A., B.M., S.R.) and the Institute of Epilepsies (E.H., P.R., S.R.), Hospices Civils de Lyon and Lyon 1 University; Lyon's Neuroscience Research Center (V.A., B.M., P.R., S.R.), INSERM U1028/CNRS UMR 5292, Lyon, France; the Hospital of Clinics of Ribeirão Preto (V.A.), University of São Paulo, Brazil; the Department of Neurology (L.V., M.D.), University Hospital of Toulouse; the Neurology Department (L.M., J.J.), University Hospital of Nancy; the Clinical Neurophysiology and Epileptology Department (F.B.), Timone Hospital, Marseille; the Department of Clinical Neurophysiology (W.S.), Lille University Medical Center, EA 1046, University of Lille2; the Department of Neurology (E.H.), University Hospital of Strasbourg; the Department of Neurology (C.M.), Hôpital Pellegrin, Bordeaux; the Epilepsy Unit (F.C.), Department of Neurosurgery, Centre Hospitalier Sainte-Anne; University Paris Descartes; La Teppe Epilepsy Center (J.P.), Tain l'Hermitage; the Epilepsy Unit (A.C.), Montpellier; the Department of Neurology (A.N.), University Hospital of Rennes; the Epileptology Unit (V.N.), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière and Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC University Paris 06), Paris; the Department of Neurology (P.K.), Michallon Hospital, GIN, INSERM U836, UJF, Grenoble Alpes University, Grenoble; the Department of Clinical Neurophysiology (B.D.T.), INSERM U930, University Hospital of Tours; the Department of Neurology (P.T.), University Hospital of Nice; the Department of Neurology (S.R.), University Hospital of Clermont-Ferrand, France; and the Department of Clinical Neurosciences (P.R.), Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland. sylvain.rheims@univ-lyon1.fr.

PMID: 26333799
DOI: 10.1212/WNL.0000000000001949

Multicenter Study

Risk factors of postictal generalized EEG suppression in generalized convulsive seizures

Veriano Alexandre et al. Neurology. 2015.

. 2015 Nov 3;85(18):1598-603.

doi: 10.1212/WNL.0000000000001949. Epub 2015 Sep 2.

Authors

Collaborators

REPO2MSE study group:
Cécile Marchal, Dominique Sarah Rosenberg, Philippe Kahane, Lorella Minotti, Laurent Vercueil, Cécile Sabourdy, Jérome Petit, Didier Tourniaire, Vieira Eid, Philippe Derambure, William Szurhaj, Louise Tyvaert, Philippe Ryvlin, Sylvain Rheims, Jean Isnard, Helène Catenoix, Fabrice Bartolomei, Agnes Trebuchon, Aileen Mc Gonigal, Sandrine Aubert, Arielle Crespel, Philippe Gelisse, Louis Maillard, Jean-Pierre Vignal, Jacques Jonas, Pierre Thomas, Véronique Bourg, Francine Chassoux, Elisabeth Landre, Vincent Navarro, Sophie Dupont, Claude Adam, Arnaud Biraben, Anca Nica, Edouard Hirsch, Maria-Paolo Valenti, Julia Scholly, Luc Valton, Marie Denuelle, Bertrand De Toffol

Affiliations

¹ From the Department of Functional Neurology and Epileptology (V.A., B.M., S.R.) and the Institute of Epilepsies (E.H., P.R., S.R.), Hospices Civils de Lyon and Lyon 1 University; Lyon's Neuroscience Research Center (V.A., B.M., P.R., S.R.), INSERM U1028/CNRS UMR 5292, Lyon, France; the Hospital of Clinics of Ribeirão Preto (V.A.), University of São Paulo, Brazil; the Department of Neurology (L.V., M.D.), University Hospital of Toulouse; the Neurology Department (L.M., J.J.), University Hospital of Nancy; the Clinical Neurophysiology and Epileptology Department (F.B.), Timone Hospital, Marseille; the Department of Clinical Neurophysiology (W.S.), Lille University Medical Center, EA 1046, University of Lille2; the Department of Neurology (E.H.), University Hospital of Strasbourg; the Department of Neurology (C.M.), Hôpital Pellegrin, Bordeaux; the Epilepsy Unit (F.C.), Department of Neurosurgery, Centre Hospitalier Sainte-Anne; University Paris Descartes; La Teppe Epilepsy Center (J.P.), Tain l'Hermitage; the Epilepsy Unit (A.C.), Montpellier; the Department of Neurology (A.N.), University Hospital of Rennes; the Epileptology Unit (V.N.), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière and Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC University Paris 06), Paris; the Department of Neurology (P.K.), Michallon Hospital, GIN, INSERM U836, UJF, Grenoble Alpes University, Grenoble; the Department of Clinical Neurophysiology (B.D.T.), INSERM U930, University Hospital of Tours; the Department of Neurology (P.T.), University Hospital of Nice; the Department of Neurology (S.R.), University Hospital of Clermont-Ferrand, France; and the Department of Clinical Neurosciences (P.R.), Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland.
² From the Department of Functional Neurology and Epileptology (V.A., B.M., S.R.) and the Institute of Epilepsies (E.H., P.R., S.R.), Hospices Civils de Lyon and Lyon 1 University; Lyon's Neuroscience Research Center (V.A., B.M., P.R., S.R.), INSERM U1028/CNRS UMR 5292, Lyon, France; the Hospital of Clinics of Ribeirão Preto (V.A.), University of São Paulo, Brazil; the Department of Neurology (L.V., M.D.), University Hospital of Toulouse; the Neurology Department (L.M., J.J.), University Hospital of Nancy; the Clinical Neurophysiology and Epileptology Department (F.B.), Timone Hospital, Marseille; the Department of Clinical Neurophysiology (W.S.), Lille University Medical Center, EA 1046, University of Lille2; the Department of Neurology (E.H.), University Hospital of Strasbourg; the Department of Neurology (C.M.), Hôpital Pellegrin, Bordeaux; the Epilepsy Unit (F.C.), Department of Neurosurgery, Centre Hospitalier Sainte-Anne; University Paris Descartes; La Teppe Epilepsy Center (J.P.), Tain l'Hermitage; the Epilepsy Unit (A.C.), Montpellier; the Department of Neurology (A.N.), University Hospital of Rennes; the Epileptology Unit (V.N.), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière and Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC University Paris 06), Paris; the Department of Neurology (P.K.), Michallon Hospital, GIN, INSERM U836, UJF, Grenoble Alpes University, Grenoble; the Department of Clinical Neurophysiology (B.D.T.), INSERM U930, University Hospital of Tours; the Department of Neurology (P.T.), University Hospital of Nice; the Department of Neurology (S.R.), University Hospital of Clermont-Ferrand, France; and the Department of Clinical Neurosciences (P.R.), Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland. sylvain.rheims@univ-lyon1.fr.

PMID: 26333799
DOI: 10.1212/WNL.0000000000001949

Abstract

Objective: To identify the clinical determinants of occurrence of postictal generalized EEG suppression (PGES) after generalized convulsive seizures (GCS).

Methods: We reviewed the video-EEG recordings of 417 patients included in the REPO2MSE study, a multicenter prospective cohort study of patients with drug-resistant focal epilepsy. According to ictal semiology, we classified GCS into 3 types: tonic-clonic GCS with bilateral and symmetric tonic arm extension (type 1), clonic GCS without tonic arm extension or flexion (type 2), and GCS with unilateral or asymmetric tonic arm extension or flexion (type 3). Association between PGES and person-specific or seizure-specific variables was analyzed after correction for individual effects and the varying number of seizures.

Results: A total of 99 GCS in 69 patients were included. Occurrence of PGES was independently associated with GCS type (p < 0.001) and lack of early administration of oxygen (p < 0.001). Odds ratio (OR) for GCS type 1 in comparison with GCS type 2 was 66.0 (95% confidence interval [CI 5.4-801.6]). In GCS type 1, risk of PGES was significantly increased when the seizure occurred during sleep (OR 5.0, 95% CI 1.2-20.9) and when oxygen was not administered early (OR 13.4, 95% CI 3.2-55.9).

Conclusion: The risk of PGES dramatically varied as a function of GCS semiologic characteristics. Whatever the type of GCS, occurrence of PGES was prevented by early administration of oxygen.

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Comment in

SUDEP: The death of nihilism.
Devinsky O, Nashef L. Devinsky O, et al. Neurology. 2015 Nov 3;85(18):1534-5. doi: 10.1212/WNL.0000000000001948. Epub 2015 Sep 2. Neurology. 2015. PMID: 26333796 No abstract available.
Risk factors of postictal generalized EEG suppression in generalized convulsive seizures.
Tao JX. Tao JX. Neurology. 2016 Mar 22;86(12):1171. doi: 10.1212/WNL.0000000000002534. Neurology. 2016. PMID: 27001990 No abstract available.
Author Response.
Rheims S. Rheims S. Neurology. 2016 Mar 22;86(12):1171. Neurology. 2016. PMID: 27447019 No abstract available.

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Risk factors of postictal generalized EEG suppression in generalized convulsive seizures

Collaborators

Affiliations

Risk factors of postictal generalized EEG suppression in generalized convulsive seizures

Authors

Collaborators

Affiliations

Abstract

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MeSH terms

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Medical