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- Roodakker, Kenney Roy, 1989-, et al.
(författare)
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Ecstatic and gelastic seizures relate to the hypothalamus
- 2020
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Ingår i: Epilepsy & Behavior Reports. - : Elsevier BV. - 2589-9864. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Ecstatic seizures constitute a rare form of epilepsy, and the semiology is diverse. Previously, brain areas including the temporal lobe and the insula have been identified to be involved in clinical expression. The aim of this report is to review changes in ecstatic seizures in a patient before and after operation of a hypothalamic hamartoma, and to scrutinize the relation to gelastic seizures. In this case, the ecstatic seizures disappeared after surgery of the hamartoma but reappeared eleven years later. Clinical information was retrospectively obtained from medical records, interviews, and a questionnaire covering seizure semiology that pertained to ecstatic and gelastic seizures. Our findings imply a possible connection between gelastic and ecstatic seizures, originating from a hypothalamic hamartoma. To our knowledge, this location has not previously been described in ecstatic seizures. Gelastic seizures may in this case were associated with ecstatic seizures. We speclate patients with ecstatic seizures may have an ictal activation of neuronal networks that involves the insula. Our case may add information to the growing knowledge concerning ecstatic seizures.
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| 2. |
- Roodakker, Kenney Roy, 1989-, et al.
(författare)
-
Ecstatic and gelastic seizures related to the hypothalamus
- 2021
-
Ingår i: Epilepsy & Behavior Reports. - : Elsevier. - 2589-9864. ; 16
-
Tidskriftsartikel (refereegranskat)abstract
- Ecstatic seizures constitute a rare form of epilepsy, and the semiology is diverse. Previously, brain areas including the temporal lobe and the insula have been identified to be involved in clinical expression. The aim of this report is to review changes in ecstatic seizures in a patient before and after operation for a hypothalamic hamartoma, and to scrutinize the relation to gelastic seizures. In this case, the ecstatic seizures disappeared after surgery of the hamartoma but reappeared eleven years later. Clinical information was retrospectively obtained from medical records, interviews, and a questionnaire covering seizure semiology that pertained to ecstatic and gelastic seizures. Our findings imply a possible connection between gelastic and ecstatic seizures, originating from a hypothalamic hamartoma. To our knowledge, this location has not previously been described in ecstatic seizures. Gelastic seizures may in this case be associated with ecstatic seizures. We speculate that patients with ecstatic seizures may have an ictal activation of neuronal networks that involve the insula. Our case may add information to the knowledge concerning ecstatic seizures. (C) 2020 The Authors. Published by Elsevier Inc.
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| 3. |
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| 4. |
- Roodakker, Kenney Roy, 1989-, et al.
(författare)
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Functional Connectivity Changes of the Brain Related to Ecstatic Seizures
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION The origin of ecstatic seizures has previously been linked to the temporal lobe and/or the anteriordorsal insula. The aim of this study was to further investigate a possible anatomical–functional network, involving theinsula, possibly behind these seizures. In this article we describe changes in seizure semiology and MRI connectivityprior to and after the surgical removal of a hypothalamic hamartoma, in order to scrutinize the functional connectivitychanges of the brain related to ecstatic seizures. METHODS A clinical/neurological longitudinal follow-up study wasconducted after hamartoma removal in a patient with a history of gelastic and ecstatic seizures prior to surgery. Datafrom MRI investigations performed at three different time points were merged with clinical information on presurgicalsemiology and its development 1-year and 11-years postsurgically. Native MRI sequences were analyzed within theMontreal Neurological Institute (MNI) space to create a region of interest (ROI) of the lesion volume. The white matterarchitecture of an average brain from the Human Connectome Project (HCP) template was used to reconstruct thewhite matter bundles according to the ROI in our MRI investigations. The reconstructed white matter connectivity wasanalyzed using cortical and subcortical areas imported from Freesurfer© atlas and displayed as circle graphs.RESULTS The clinical course of the ecstatic symptoms merged with the connectivity analysis showed three potentialareas of the brain possibly involved in ecstatic seizures: the left superior frontal gyrus, the brainstem and the leftthalamus. The white matter pathways between hypothalamus-thalamus and brainstem were particularly representedwhen the ecstatic phenomena were present, whereas the absence of ecstatic seizures in the postoperative periodseemed to be connected with the predominant involvement of the fronto-thalamic-brainstem network. CONCLUSIONWe suggest that a balance of the networks between the thalamus, the brain stem and the frontal lobe is crucial inorder to experience ecstatic seizures. Our results indicate that the frontal lobe is involved in the inhibitoryeffect/negative reinforce, while the brain stem and a gelastic seizure may elicit a positive trigger/reinforce of theecstatic seizure. Additionally, our findings suggest a possible connection between gelastic and ecstatic seizures. Thisnew information about the possible functional organization supports the notion that it is a network rather than just asingle trigger zone that produces the complex pattern of symptoms seen in patients with ecstatic epileptic seizures.
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