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2014 ; 83
(16
): 1444-9
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Auras in generalized epilepsy
#MMPMID25230998
Dugan P
; Carlson C
; Bluvstein J
; Chong DJ
; Friedman D
; Kirsch HE
Neurology
2014[Oct]; 83
(16
): 1444-9
PMID25230998
show ga
OBJECTIVE: We studied the frequency of auras in generalized epilepsy (GE) using a
detailed semistructured diagnostic interview. METHODS: In this cross-sectional
study, participants with GE were drawn from the Epilepsy Phenome/Genome Project
(EPGP). Responses to the standardized diagnostic interview regarding tonic-clonic
(grand mal) seizures were then examined. This questionnaire initially required
participants to provide their own description of any subjective phenomena before
their "grand mal seizures." Participants who provided answers to these questions
were considered to have an aura. All participants were then systematically
queried regarding a list of specific symptoms occurring before grand mal
seizures, using structured (closed-ended) questions. RESULTS: Seven hundred
ninety-eight participants with GE were identified, of whom 530 reported grand mal
seizures. Of these, 112 (21.3%) reported auras in response to the open-ended
question. Analysis of responses to the closed-ended questions suggested that 341
participants (64.3%) experienced at least one form of aura. CONCLUSIONS: Auras
typically associated with focal epilepsy were reported by a substantial
proportion of EPGP subjects with GE. This finding may support existing theories
of cortical and subcortical generators of GE with variable spread patterns.
Differences between responses to the open-ended question and closed-ended
questions may also reflect clinically relevant variation in patient 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 the
underrecognition of auras in GE. In addition, structured questions may influence
participants, possibly leading to a greater representation of symptoms.
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