Auras in Generalized Epilepsy

Types of seizures
Wednesday, October 15, 2014

In the September 17, 2014, Neurology articles published ahead of print, Doctors Dugan and colleagues, on behalf of the Epilepsy Phenome/Genome Project (EPGP) Investigators, present an important manuscript on auras in generalized epilepsy. It is assumed that auras only occur in focal or partial seizures. The investigators of the EPGP study, which addressed the clinical epilepsy findings related to the genetics of epilepsy, assess the report of auras in people who have generalized tonic-clonic or grand mal seizures. 

The Study and What it Found

  • During the study, 798  participants were identified of whom 530 reported generalized tonic-clonic or grand mal seizures. 
  • Of these, 112, or 21.3%, reported auras in response to open-ended questions. 
  • Analysis of responses to close-ended questions suggested that 341 participants, or 64.3%, experience at least one form of aura.

What the Results Mean

  • The investigators conclude that auras typically associated with focal epilepsy were reported by a substantial proportion of EPGP patients with generalized epilepsy. 
  • This finding may support the series of cortical and sub-cortical generations of generalized epilepsy with variable spread patterns. 
  • Differences between responses to the open-ended questions and close-ended questions may also reflect clinically relevant variations in people’s responses to history taking and surveys.
  • Open-ended questions may underestimate the prevalence of specific types of auras and may be in part responsible for their under recognition of auras in generalized epilepsy.
Authored by: Joseph I Sirven, MD on 10/2014

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