Abstracts of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S77

Alzheimer’s disease. Memory impairment is fairly common symptom ofepilepsy and it seems interesting to study the fronto-parietal coherence inepilepsy.Patients and methods: We examined 34 people with partial epilepsy, themean age was 32.9 years, and 17 healthy control groop, the mean age was30.5 years. For EEG recording, we used the 19-channel EEG (10-20%) andmathematical processing package “Neuron-Spectrum” (Russia). Recordingtook place in a resting state, was used for the analysis of the record for 20seconds without artifacts. Estimation of the spectral coherence of the thetarhythm was conducted in the following leads: F3-P3, F4-P4, F3-F4, P3-P4.Subjects performed a test for short-term memory “Digit Span”.Results: Memory deficits were found in 58% (20) of patients, in the controlgroup of memory impairment has not been. Fronto-parietal coherence inpatients with memory decline differed significantly (p=0.001) from healthyand patients without memory impairment. Fronto-parietal coherence levelin the group with memory impairment decreased depending on the amountof digits in the test (p=0.005).Conclusion: We assume that the fronto-parietal scalp EEG coherence mayplay a role in the assessment of cognitive impairment in patients withepilepsy.

P107Electrocorticographic evidence and surgical implications of differentpathophysiologic subtypes of temporal lobe epilepsy

O. Garnes-Camarena1, L. Vega-Zelaya1, C. Torres2, G. Ortega2, M. Navas2,R.G. Sola2, J. Pastor11La Princesa Hospital, Clinical Neurophysiology, Madrid, Spain; 2La PrincesaHospital, Neurosurgery, Madrid, Spain

Question: Mesial temporal lobe epilepsy (MTLE) might have a focal ora network pathophysilogy. We hypothesize that changes in the interictalspiking activity during electrocorticography (ECoG) reflect changes occur-ring in the epileptic network. The elimination of mesial interictal spikes istightly linked with the epileptogenic zone (EZ) resection.Methods: 25 patients diagnosed with MTLE were intraoperatively evalu-

Figure 1

ated by ECoG with a 4×5 grid over the lateral temporal cortex and an8-electrode mesial strip. Total Spiking Activity (TSA), defined as the meanspikes/min for all mesial channels, was computed before and after lateralcortectomy (LC). Based on the TSA after LC, a tailored anterior medialtemporal resection (AMTR) was carried out.Results: At the last follow-up (19.1±1.4 months), patients were character-ized as Engel’s class I: 84%, II: 8%, or III: 8%. During LC, TSA recorded fromthe mesial strip did not change in 14 patients, increased in 3 patients anddecreased in 8 patients. In 20% of patients, the mesial activity completelydisappeared following the LC, and mesial structures were spared. All ofthese patients were Engel’s class IA. The TSA in the mesial strip during thebasal recording was located in the occipital region (80%) and did not changeafter LC.

Figure 2

Conclusions: Our results strongly suggest the existence of pathophysiologicdifferences within subtypes of MTLE. The identification of these subtypes isfundamental for an individualized surgical approach.

P108Long-term clinical and EEG consequences of idiopathic partialepilepsies

N. Doertcan1, B. Tekin Gueveli2, A. Dervent31Fatih Sultan Mehmet Research and Training Hospital, Neurology, Istanbul,Turkey; 2Bakirkoy Research and Training Hospital for Psychiatry, Neurology,Neurosurgery, Neurology, istanbul, Turkey; 3Private office, Neurology, Istanbul,Turkey

This study includes 61 consecutive patients followed by ourselves in aprivate office. All patients were diagnosed as having idiopathic partialepilepsy (IPE) and followed by for 3–18 years, mean 8 yearsAccordingto syndromic classification of epilepsies and epileptic syndromes, patientswere gathered into diagnostic groups as 1: Benign Rolandic Epilepsy (BRE),2: Panayiotopoulos Syndrome (PS), 3: Childhood Epilepsy with OccipitalParoxsyms (Gastaut-type), 4: Atypical Benign Partial Epilepsy (ABPE) and 5:Cases with intermediate characteristics.

S78 Abstracts of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339

Main parameters evaluated in the study were age at onset of epilepsy,seizure characteristics as type, frequency, duration, relation with sleep-wake cycle, patient and family history for paroxysmal disorders and clinicalcourse of the seizures. Distribution of interictal spike-wave in the EEGswere analyzed and their localizations were questioned in relation to age ofthe patient at the time of recording.Number of patients with typical BRE was 17, PS 9, Childhood Epilepsywith Occipital Paroxsyms (Gastaut-type) 8 and ABPE 1. Remaining patientsexhibited either characteristics common for more than one syndrome, or,some features within the borderlines of IPEs.Ratio of patients with idiopathic epilepsy in at least one family memberwas % 38 and with parental consanguinity was % 8Spike distribution in the EEGs was not only related to the syndromiccharacteristics of the patients but also to the age at the EEG recording.Results are discussed in view of the related literature.

P111Dacrystic status epilepticus: a case report

M. Vicente Rasoamalala1, E. Lainez1, V. Thonon1, M. Raspall21Hospital Vall d’Hebron, Clinical Neurophysiolgy, Barcelona, Spain; 2HospitalVall d’Hebron, Pediatric Neuology, Barcelona, Spain

Question: To describe the clinical and electrographic features of a patientwho presented a status epilepticus of persistent crying.Methods: Twelve year-old girl who was admitted in our hospital forheadache, nausea, left upper limb paresis and dysarthria without fever thatprogressively evolved to a mental state alteration with persistent unmoti-vated crying. She received a cord blood transplantation for the treatmentof a chronic myeloid leukemia six months ago. Cerebrospinal fluid analysiswas negative for the most frequent viral and bacterial infectious agents.Cranial MRI revealed only a decreased diameter of M2-M3 segments ofright median cerebral artery. Serial EEG recordings were performed.Results: EEG initially showed a focal slow activity in right fronto-temporalregions. 24 hours after we found profuse interictal epileptiform activitylocalized in temporal and frontal left hemisphere regions and in frontalright hemisphere region with a slowed background activity. A consecutiveEEG performed 2 days after showed bifrontal rhythmic 2.5 Hz delta wavespreceded by sharp waves that disappeared with the administration ofendovenous midazolam bolus (5 mg); after that it persisted some interictalabnormalities in the recording; mental state improved and crying wasno more present. An antiepileptic treatment was instaured (levetiracetamand lacosamide) producing a resolution of clinical manifestations and anormalisation of EEG recordings.Conclusion: Dacrystic seizures are a very infrequent ictal manifestation.They usually have a focal origin, mostly in fronto-temporal non-dominanthemisphere regions. We present a unique case of dacrystic status epilepti-cus without an elucidated etiology.

P112Perspectives of neurosurgical treatment of epilepsy patients inresource poor countries – study in Georgia

S. Kasradze1,2, G. Lomidze1,2

1Georgian Sleep research and Sleep medicine society, Clinical Neurophysiology,Tbilisi, Georgia; 2Institute of Neurology and Neuropsychology, Tbilisi, Georgia

Question: Focal brain abnormalities are major risk factors for pharmacore-sistant epilepsy (PRE) andsurgical treatment of these patients is the mosteffective way. In resource limited countries epilepsy surgery is not largelyaccessible because of restricted availability of intracranial EEG monitoringand functional brain imaging, that leads to complete stagnation ofdevelopment of epilepsy surgery. However, not all patients require furtherdiagnostic procedures, if there is unequivocal concordance in seizure semi-ology, localization of brain lesion on MRI and epielptiform activity on EEG.Aim: To estimatethe rate ofconcordancebetween seizure semiology, EEGandMRIdatain people with PRE.Methods: Patients with uncontrolled seizures were recruited at Institute ofNeurology and Neuropsychology, admitted between 2009-2012 years. All ofthem were clinically reexamined, underwent standard 20-minute interictalEEG and a high-resolution MRI (3T) according to epilepsy protocol.Pharmacoresistance was defined according to Kwan, et al. 2010. Epilep-tiform EEG abnormalities were defined as focal epileptiform discharges:spikes, spike-wave complexes, and sharp waves.

Results: 82 persons were investigated (mean age 26 years, SD 12). Fiftyfive (67%) were female. MRI revealed: mesial sclerosis - 15 case (18%),focal cortical dysplasia (FCD) - 5, tuberous sclerosis - 2 and brain tumour3 cases. No lesion was found in 24 (29%) cases. In remaining 38 patientsvarious brain abnormalities were detected. Localization of possibly epilep-togenic lesions on MRI was in concordance with seizure semiology and EEGfindings in 15 (18%) cases (mesial sclerosis - 11, FCD - 2, polymicrogiria -1, hypothalamic hamartoma - 1). In 22 (27%) cases ambiguous data wereobtained. In remaining 21 (26%) people multifocal or diffuse abnormalitieswere detected that were irrelevant for epilepsy surgery.Conclusion: According to our study, in up to one-fifth of patients couldbe considered as good candidates for epilepsy surgery without needs offurther high technological pre-operative assessment procedures. However,most patients in our cohort require more deep investigations for properlocalisation of epileptogenic focus.Acknowledgement: The study was funded from Shota Rustaveli NationalScience Foundation grant.

P113Correlation of neuropsychological and electrophysiological findings inpatients with epilepsy

T. Gagoshidze1,2, S. Kasradze1

1Institute of Neurology and Neuropsychology, Neuropsychology, Tbilisi,Georgia; 2Iv. Javakhishvilis Tbilisi State University, Psychology, Tbilisi, Georgia

Question: The goal of the study was to investigate the correlations of neu-ropsychological and electrophysiological data in adult patients admitted atEpilepsy Centre for diagnosis of epilepsy.Methods: Standard EEG and Neuropsychological findings of persons withage range of 18-79 years, admitted at the Epilepsy Centre (01.01.2011–31.12.2012) of the Institute of Neurology and Neuropsychology (INN) fordiagnosis of epilepsy were analyzed. Brief Neuropsychological Test foradults was compiled from A. Luria’s neuropsychological tests and A. Ben-ton Visual Memory Retention Test. Luria’s syndrome analysis approachwas used for neuropsychological conclusion and probable localization ofbrain dysfunction. EEG criteria for identification of prevalent localiza-tion of pathological area were mainly sharp waves, pick-waves, poly-pickwaves and pick and slow waves. Statistical procedures for categorical data,non-parametric statistics: phi correlation, Pearson χ2 coefficient were used.Results: After multidisciplinary investigations of 585 people, 255 male/320female, 101 persons were diagnosed as having non-epileptic seizures, 113– with Generalized Epilepsy, 371 – with Focal Epilepsy.From total group 548 (93.7%) had pathological indicators on EEG and outof them the normal neuropsychological functioning has only 55 (10%); inremaining 37 persons with normal EEG normal neuropsychological func-tioning were reviled in 22 cases (61%). Comparing Generalized, Focal andnon-epilepsy seizures, there was a moderate to severe neuropsychologicaldysfunction in the group of focal epilepsies and no or mild dysfunction inpersons with non-epileptic seizures (χ2=77.395, p<0.005).High concordance revealed between EEG and Neuropsychological datain case of frontal, frontal-temporal, frontal-temporal-parietal localizations(PC=0.693, p<0.024, Cramer’s V=0.231, p<0.05, CC=0.569, p<0.05). Nocompatibility was in cases of occipital localization.Conclusions: There is a high correlation of EEG and neuropsychologicalfindings especially in frontal and fronto-temporal epilepsies. Neuropsy-chological assessment could easily capture temporal lobes dysfunction incombination with other brain regions, then pure temporal area’s dysfunc-tion. Failure in occipital localization coincidence can be explained by theweakness of neuropsychological test in identification of occipital lobesdysfunction.

P117Quantitative EEG alterations in alcohol-dependent patients withepileptic seizures – pilot study

M. Nowakowska-Kotas, E. Kowalczyk, M. Waliszewska-Prosół,A. Pokryszko-DraganWroclaw Medical University, Department of Neurology, Wroclaw, Poland

Question: The aim of study was to analyze features of quantitative elec-troencephalography (qEEG) in alcohol- dependent subjects with epilepticseizures.Methods: The study comprised 24 alcohol-dependent patients (19 men, 5