Periventricular leukomalacia and epilepsy
Incidence and seizure pattern
- C. Gurses, MD,
- D.W. Gross, MD, FRCP(C),
- F. Andermann, MD, FRCP(C),
- A. Bastos, MD,
- F. Dubeau, MD, FRCP(C),
- M. Calay, MD,
- M. Eraksoy, MD,
- S. Bezci, MD,
- E. Andermann, MD, PhD and
- D. Melanson, MD
- From the Montreal Neurological Institute and Hospital (Drs. GursesGross, Bastos, Dubeau, Andermann, and Melanson), McGill University, Montreal, Quebec, Canada; Istanbul University Neurological Sciences Institute (Drs. Gurses, Calay, and Eraksoy), Department of Neurology, and Turkish Spastic Children’s Society (Dr. Bezci), Department of Pediatrics, Istanbul, Turkey.
- Address correspondence and reprint requests to Dr. Frederick Andermann, Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, Quebec, Canada H3A 2B4.
Abstract
Objective: To study the incidence and pattern of epilepsy in patients with periventricular leukomalacia (PVLM) in two specialty clinic settings.
Background: Motor and cognitive deficit as well as epilepsy are common in patients with PVLM. With modern imaging techniques, PVLM is now easily recognized.
Methods: Epileptic seizures and syndromes as well as motor and cognitive deficits were correlated with MRI findings. Two patient populations were studied: Group A—children with cerebral palsy and PVLM presenting to a center for children with motor disability (n = 19); and Group B—epileptic patients with PVLM presenting to a tertiary epilepsy center (n = 12). A single patient with PVLM and epilepsy who underwent extensive investigations, including intracranial EEG telemetry, is reported.
Results: In Group A, 47% of patients had epilepsy (9/19). PVLM was found in 1.27% of patients investigated for epilepsy at a tertiary epilepsy center (12/942). The majority of patients in both groups had multiple seizure types, with complex partial seizures being most common. Of patients with seizures (Groups A and B), 85.7% had intractable epilepsy (18/21). Intracranial EEG in the illustrative case demonstrated a multifocal epileptic process with occipitotemporal predominance.
Conclusions: PVLM was an uncommon underlying cause in patients presenting with epilepsy (Group A); however, patients presenting with motor disability and PVLM (Group B) had a high incidence of seizures. PVLM in epileptic patients is associated with multiple seizure types and medically refractory disease.
- Received March 13, 1998.
- Accepted November 17, 1998.
