The clinical presentation and diagnosis of epileptic autonomic auras

Abstract

Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA) and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women) aged 9 to 27years (mean 18±5years) were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI) of the brain. Results. In most patients (n = 12, 67%), the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG) were present in the frontal, temporal, and frontotemporal regions in 4 (22%), 6 (33%), and 7 (39%) patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72%) patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.

Keywords

• epilepsy
• autonomic epileptic aura
• electroencephalography
• video-assisted electroencephalographic monitoring
• magnetic resonance imaging