PMID- 23551088
OWN - NLM
STAT- MEDLINE
DCOM- 20130625
LR  - 20220317
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 54
IP  - 5
DP  - 2013 May
TI  - Patterns of cortical hyperexcitability in adolescent/adult-onset generalized 
      epilepsies.
PG  - 871-8
LID - 10.1111/epi.12151 [doi]
AB  - PURPOSE: To investigate whether using transcranial magnetic stimulation (TMS) to 
      derive if measures of cortical excitability changes can distinguish between 
      various adolescent/adult-onset generalized epilepsy syndromes at different phases 
      of the disorder. METHODS: One hundred thirty-seven patients with 
      adolescent/adult-onset generalized epilepsy divided into juvenile myoclonic 
      epilepsy, juvenile absence epilepsy, and generalized epilepsy with tonic-clonic 
      seizures only were studied. The cohorts were further divided into drug naive-new 
      onset, refractory, and seizure-free groups. Motor threshold (MT) and paired pulse 
      TMS at short (2, 5, 10, 15 msec) and long (100-300 msec) interstimulus intervals 
      (ISIs) were measured. Results were compared to those of 20 controls. KEY 
      FINDINGS: In the drug-naive cohorts MT was reduced (p < 0.05) and cortical 
      excitability increased at 2 and 5 msec and 150, 250, and 300 msec ISIs (p < 0.01) 
      in juvenile myoclonic epilepsy compared to other generalized epilepsy groups and 
      controls. Cortical excitability increased to a lesser degree in other generalized 
      epilepsy syndromes compared to controls, but those two syndromes were not 
      distinguishable from one another. The changes in paired pulse TMS were more 
      prominent in the groups with refractory seizures and very small in the groups who 
      were seizure free. SIGNIFICANCE: There are syndrome specific changes in cortical 
      excitability associated with generalized epilepsy. These changes are also 
      dependent on seizure control with medication. Juvenile myoclonic epilepsy has a 
      higher cortical excitability profile compared to other adolescent/adult-onset 
      generalized epilepsy syndromes and can be clearly distinguished from them during 
      all phases.
CI  - Wiley Periodicals, Inc. (c) 2013 International League Against Epilepsy.
FAU - Badawy, Radwa A B
AU  - Badawy RA
AD  - Department of Clinical Neurosciences, St Vincent's Hospital, Fitzroy, Victoria, 
      Australia. badawyr@unimelb.edu.au
FAU - Vogrin, Simon J
AU  - Vogrin SJ
FAU - Lai, Alan
AU  - Lai A
FAU - Cook, Mark J
AU  - Cook MJ
LA  - eng
PT  - Journal Article
DEP - 20130329
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age of Onset
MH  - Cerebral Cortex/*physiopathology
MH  - Cohort Studies
MH  - Epilepsy, Absence/*pathology/physiopathology
MH  - Epilepsy, Generalized/*pathology/*physiopathology
MH  - Evoked Potentials, Motor/*physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Myoclonic Epilepsy, Juvenile/*pathology
MH  - Time Factors
MH  - Transcranial Magnetic Stimulation
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/04/05 06:00
MHDA- 2013/06/26 06:00
CRDT- 2013/04/05 06:00
PHST- 2013/02/13 00:00 [accepted]
PHST- 2013/04/05 06:00 [entrez]
PHST- 2013/04/05 06:00 [pubmed]
PHST- 2013/06/26 06:00 [medline]
AID - 10.1111/epi.12151 [doi]
PST - ppublish
SO  - Epilepsia. 2013 May;54(5):871-8. doi: 10.1111/epi.12151. Epub 2013 Mar 29.