UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS

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2025-04-09 5:18
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Conference: Bucharest University Faculty of Physics 2016 Meeting


Section: Biophysics; Medical Physics


Title:
Successful Epilepsy Surgery in Startle Epilepsy


Authors:
Ana GHEORGHIU (CIUREA) (1,2,3) Jean CIUREA (3), Alin RĂȘINA (3), Ioan OPRIS (4), Radu MUTIHAC(1)


Affiliation:
1. University of Bucharest, Faculty of Physics, Magurele, Romania

2. Neurology Department, Neurology and Neurovascular Diseases National Institute, Bucharest, Romania

3. Neurosurgery Department, Bagdasar-Arseni Hospital Bucharest

4. University of Miami, Miami Project to Cure Paralysis, USA.




E-mail
anagheorghiu88@gmail.com


Keywords:
Intractable epilepsy, startle syndrome, SEEG investigation, epileptogenic network


Abstract:
Startle epilepsy is a rare type of epilepsy in which the trigger is often a sudden and unexpected stimulus. The involvement of anatomical regions (like the rolandic sensory-motor area or supplementary motor area-SMA) is usually correlated with this type of epilepsy. Case report This is a case report of a 33 years old male, with intractable epilepsy, categorized as a startle syndrome. In our case the patient did not have a visible lesion on MRI and the seizure semiology did not indicate a clear lateralization. We performed presurgical evaluation using depth electrodes and we found a large epileptogenic network including a large number of anatomical regions. A good outcome was obtained after tailored frontal mesial resection, using accurate SEEG investigation. Histopathological analysis revealed a type I focal cortical dysplasia. One year after surgery the patient was seizure-free. Discussions and conclusions In this case a large epileptogenic network was involved. The patient had a very good outcome after surgery. Postoperative seizure freedom and positive histopathological result confirms that we explored and removed the right structures.


References:

1. Fern�ndez S., Donaire A. et al. Functional neuroimaging in startle epilepsy: Involvement of a mesial frontoparietal network, Epilepsia, 52(9):1725�1732, 2011doi: 10.1111/j.1528-1167.2011.03172.x

2. Job A.-S., De Palma L.,Principe A. et al. The pivotal role of the supplementary motor area in startle epilepsy as demonstrated by SEEG epileptogenicity maps. Epilepsia, 55(8):e85-e88, 2014 doi: 10.1111/epi.12659

3.Manford MRA, Shorvon SD. Startle provoked epileptic seizures: features in 19 patients. J Neurol Neurosurg Psychiatry 1996; 61: 151-156

4. Szucs A., Rasonyi G., Orbay P. et al. Are proprioceptive-induced reflex seizures epileptically-enhanced stretch reflex manifestations?. Epileptic Disord 2012; 14 (2): 149-54

5. Klinkenberg S., Ubbink S., Vles J. et al. Noninvasive treatment alternative for intractable startle epilepsy.Epilepsy & Behavior Case Reports 2 (2014) 49�53

Acknowledgement:
Ana Gheorghiu (Ciurea) was supported by the strategic grant POSDRU/159/1.5/S/133652, �Integrated system to improve the quality of doctoral and postdoctoral research in Romania and promotion of the role of science in society� cofinanced by the European Social Found within the Sectorial Operational Program Human Resources Development 2007�2011.