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      Utilidad de la electroencefalografía en las epilepsias y síndromes epilépticos de la infancia


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          Se revisó la utilización del electroencefalograma (EEG) en el manejo de las epilepsias y síndromes epilépticos, como una herramienta para el diagnóstico y pronóstico del paciente con crisis epilépticas en el área de la neuropediatría, correlacionando las manifestaciones clínicas, edad de inicio, frecuencia, pronóstico y características electroencefalográficas de los trazados de cada una de ellas. El electroencefalograma goza de una extraordinaria vigencia en las neurociencias, dado que es un instrumento del que disponemos para aproximarnos realmente al funcionamiento cerebral en tiempo reales decir, a escala de milisegundos. A pesar de que en el último decenio se ha producido un desarrollo espectacular de las técnicas de neuroimágenes y funcionales, como la tomografía axial computarizada (TAC), resonancia magnética cerebral (RM) con sus variantes funcionales, la tomografía de emisión de positrones (PET), la tomografía computarizada de emisión de fotones (SPECT) y la magnetoencefalografía (MEG), la llegada de esas técnicas no ha conseguido relegar al EEG a un papel secundario. La calidad del EEG va a depender de los datos obtenidos, de una evaluación adecuada para llegar a conclusiones valederas que se obtengan como producto de la habilidad, entrenamiento y experiencia de la persona a cargo de realizarlo. El EEG aporta el diagnóstico definitivo en muchas de las epilepsias y síndromes epilépticos de la infancia.

          Translated abstract

          The utility of the electroencephalogram (EEG) in handling childhood epilepsies and epileptic syndromes was reviewed as a diagnosis and prognosis tool in the patient with epileptic crisis. Correlations were stablished between clinical manifestations, age of onset, frequency, prognosis and electroencephalographic characteristics of the layouts of each one of the different types. EEG is extremely useful in neurosciences; since it is the only instrument that we have to assess the brain´s function in real time, that is to say, at the scale of milliseconds. Although in the last decade a spectacular development of neuroimages and functional techniques has taken place, as with computerized axial tomography (CAT), cerebral magnetic resonance (MR) with its fuctional variants, positron emission tomography (PET), photon emission computerized tomography (SPECT) and magnetoencephalography (MEG), the arrival of those techniques has not been able to relegate EEG to a secondary place. The utility of the EEG depends on an adequate evaluation that will lead to valid conclusions. The accuracy of this evaluation is related to the ability, training and experience of the operator. The EEG contributes to the definite diagnosis in many of childhood epilepsies and epileptic syndromes.

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          Most cited references109

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            Introduction to temporal lobe epilepsy.

            Epileptic disorders are classified as idiopathic when they are genetically transmitted conditions that consist of epilepsy only, with no structural lesions in the brain and no associated neurological deficits, and symptomatic when they result from some other primary brain lesion or insult. Symptomatic temporal lobe epilepsy can be further divided into mesial temporal lobe epilepsy (MTLE), the condition associated with hippocampal sclerosis; lesional temporal lobe epilepsy due to specific identifiable lesions localized to areas that preferentially project to mesial temporal structures; and cryptogenic temporal lobe epilepsy, for which no etiology can be determined. Intensive clinical and basic research on MTLE, perhaps the most common form of human epilepsy, is currently being carried out in epilepsy research centers, and a number of experimental animals models have been developed to help elucidate the pathophysiology of this condition. Animal models are also important for determining how specific lesions induce epileptogenicity, and whether the neuronal mechanisms in mesial temporal lobe limbic structures are the same as those in neocortex. Cryptogenic temporal lobe epilepsy remains a major clinical challenge, and much more information needs to be derived from research on patients before relevant experimental animal models can be created.
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              Mutations in LGI1 cause autosomal-dominant partial epilepsy with auditory features.

              The epilepsies are a common, clinically heterogeneous group of disorders defined by recurrent unprovoked seizures. Here we describe identification of the causative gene in autosomal-dominant partial epilepsy with auditory features (ADPEAF, MIM 600512), a rare form of idiopathic lateral temporal lobe epilepsy characterized by partial seizures with auditory disturbances. We constructed a complete, 4.2-Mb physical map across the genetically implicated disease-gene region, identified 28 putative genes (Fig. 1) and resequenced all or part of 21 genes before identifying presumptive mutations in one copy of the leucine-rich, glioma-inactivated 1 gene (LGI1) in each of five families with ADPEAF. Previous studies have indicated that loss of both copies of LGI1 promotes glial tumor progression. We show that the expression pattern of mouse Lgi1 is predominantly neuronal and is consistent with the anatomic regions involved in temporal lobe epilepsy. Discovery of LGI1 as a cause of ADPEAF suggests new avenues for research on pathogenic mechanisms of idiopathic epilepsies.

                Author and article information

                Role: ND
                Role: ND
                Archivos Venezolanos de Puericultura y Pediatría
                Arch Venez Puer Ped
                Sociedad Venezolana de Puericultura y Pediatría (Caracas )
                June 2007
                : 70
                : 2
                : 59-68
                [1 ] Centro Clínico Científico Esperanza Paraco Venezuela
                [2 ] Universidad de Oriente Venezuela



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0649&lng=en
                HEALTH POLICY & SERVICES

                Pediatrics,Health & Social care,Public health
                Electroencephalogram (EEG),Convulsión,Epilepsia,Electroencefalograma (EEG),Seizures


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