Occurrence of hyperventilation-induced high amplitude rhythmic slowing with altered awareness after successful treatment of typical absence seizures and a network hypothesis

Autor: Simone Mattozzi, Caterina Cerminara, Maria A. Sotgiu, Alessandra Carta, Antonella Coniglio, Denis Roberto, Delia M. Simula, Gian Luca Pruneddu, Silvia Dell'Avvento, S. Sonia Muzzu, Maria Fadda, Giovanni M. Luzzu, Stefano Sotgiu, Susanna Casellato
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Clinical Neurophysiology Practice, Vol 6, Iss , Pp 185-188 (2021)
Druh dokumentu: article
ISSN: 2467-981X
DOI: 10.1016/j.cnp.2021.03.009
Popis: Background: Typical absence seizures (AS) are epileptic phenomena typically appearing in children 4–15 years of age and can be elicited by hyperventilation (HV). Hyperventilation-induced high-amplitude rhythmic slowing (HIHARS) represents a paraphysiological response during HV and may manifest with alteration of awareness (HIHARSAA). To date, HIHARSAA has mostly been described in patients without epilepsy. Aim: To describe five patients with treatment-responsive typical AS who, after becoming seizure free, presented with HIHARSAA. Methods: By using video-electroencephalographic recording (Video-EEG), we describe differential clinical characteristics and ictal electrophysiological patterns of both typical AS and HIHARSAA. Results: We demonstrate that when HIHARSAA occurs in patients with typical AS there is a temporal window between the two phenomena. This suggests that the presence of typical AS precludes the appearance of HIHARSAA. Conclusions: We hypothesize that alkalosis and dysfunction of the same neural network are involved in both typical AS and HIHARSAA and that their distinct electroclinic manifestations are due to the involvement of different ion channels. Significance: A better understanding of the characteristics of typical AS and HIHARSAA and of the role of alkalosis in both, can help avoiding misdiagnosis and identifying more suitable therapies for typical AS.
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