JLE

Epileptic Disorders

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Startle response: epileptic or non-epileptic? The case for "flash" SMA reflex seizures Volume 3, numéro 1, Mars 2001


   
   Figure 1. Startle response triggered by a sudden noise, as shown on the video. Left: full-scale EEG and polygraphy at 15 mm/s. The startle provokes extensive muscular and movement artefacts. Right: same event, enlargement at 30 mm/s. Approximately one second after the triggering stimulus, short burst of low-voltage, fast activity may be present over FZ and CZ, followed by some slow activity over C4. The sudden tonic muscular contraction appears as very short and bilateral.



   
  

Figure 2. EEG recording performed at age 3.5 months, after a series of apparently unprovoked generalised tonic-clonic seizures. a. Left: during sleep, the presence of diffuse paroxysmal abnormalities. Note that the spikes predominate over the central and anterior leads, and on the right. b. Right: an apparently spontaneous ictal event on the same EEG recording, on waking. Note the right-central and vertex predominance of the paroxysmal changes. The paroxysmal complex was followed by low-voltage activity, more visible over the vertex and the left-central area. The clinical correlate was classified as a spasm, but remained isolated, and when the patient was seen at age 19, the parents certified that these had been the same "jerks" as in later life.