Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct-Dec;19(4):518-522.
doi: 10.4103/0972-2327.194462.

Brainstem dysfunction in patients with late-onset Lennox-Gastaut syndrome: Voxel-based morphometry and tract-based spatial statistics study

Kang Min Park  1 , Yun Jung Hur  2 , Sung Eun Kim  1
Affiliations

Brainstem dysfunction in patients with late-onset Lennox-Gastaut syndrome: Voxel-based morphometry and tract-based spatial statistics study

Kang Min Park et al. Ann Indian Acad Neurol. 2016 Oct-Dec.

Abstract

Background: There have been a few reports of patients who developed Lennox-Gastaut syndrome (LGS) in the second decades of their life.

Objectives: The aim of this study was to investigate electroclinical presentation in patients with late-onset LGS. In addition, we evaluated structural abnormalities of the brain, which may give some clue about the common pathogenic pathway in LGS.

Materials and methods: We enrolled the patients with late-onset LGS. We collected electroclinical characteristics of the patients and evaluated structural abnormalities using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis.

Results: The three subjects were diagnosed with late-onset LGS. The patients have no mental retardation and normal background activities on electroencephalography (EEG), and they had generalized paroxysmal fast activities on EEG, especially during sleep. The TBSS analysis revealed that fractional anisotropy values in the patients were significantly reduced in the white matter of brainstem compared with normal controls. However, VBM analysis did not show any significant difference between the patients and normal controls.

Conclusions: Patients with late-onset LGS have different clinical and EEG characteristics from those with early-onset LGS. In addition, we demonstrated that brainstem dysfunction might contribute to the pathogenesis of late-onset LGS.

Keywords: Brain stem; Lennox–Gastaut syndrome; magnetic resonance imaging.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The electroencephalography a patient with late-onset Lennox–Gastaut syndrome. It reveals normal background activities at 9 Hz on awaken state (a) and shows generalized paroxysmal fast activities at approximately 15–20 Hz during sleep (b) (arrow)
Figure 2
Figure 2
Tract-based spatial statistics result of fractional anisotropy images and mean diffusivity images. Red and yellow represents regions with decreased fractional anisotropy (a) and increased mean diffusivity (b) in patients compared to normal controls (arrows)
See this image and copyright information in PMC

References

    1. Bourgeois BF, Douglass LM, Sankar R. Lennox-Gastaut syndrome: A consensus approach to differential diagnosis. Epilepsia. 2014;55(Suppl 4):4–9. - PubMed
    1. Kim HJ, Kim HD, Lee JS, Heo K, Kim DS, Kang HC. Long-term prognosis of patients with Lennox - Gastaut syndrome in recent decades. Epilepsy Res. 2015;110:10–9. - PubMed
    1. Shyu HY, Lin JH, Chen C, Kwan SY, Yiu CH. An atypical case of Lennox-Gastaut syndrome not associated with mental retardation: A nosological issue. Seizure. 2011;20:820–3. - PubMed
    1. Benbadis SR, Dinner DS. Lennox-Gastaut syndrome in the elderly? Clin Electroencephalogr. 1994;25:142–7. - PubMed
    1. Camfield PR. Definition and natural history of Lennox-Gastaut syndrome. Epilepsia. 2011;52(Suppl 5):3–9. - PubMed