Recovery of consciousness during the postictal state in frontal and temporal lobe epilepsy

Lara-Maier, Susana (2021): Recovery of consciousness during the postictal state in frontal and temporal lobe epilepsy. Dissertation, LMU München: Medizinische Fakultät

Abstract

This doctoral study investigates the time that people diagnosed with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) need to give a first adequate response (FAR) during the postictal state of focal seizures as a first sign in the process of recovering consciousness (RC); it also examines the variables that could influence the time required to be able to answer the cognitive and behavioral evaluation. A quantitative research design was chosen using a descriptive and correlational approach to determine durations, identify characteristics, and correlate variables. The analyzed variables were the clinical features and the characteristics of the epileptic seizures. A retrospective investigation was performed on data of patients examined from March 2006 to December 2018 at the Epilepsy Monitoring Unit at the Hospital of the Ludwig-Maximilians University of Munich. A total of 188 patients and 332 epileptic seizures met the inclusion criteria. Patients were divided into four groups according to the localization of the epileptic seizure onset: right temporal lobe epilepsy (RTLE, n = 66), left temporal lobe epilepsy (LTLE, n = 85), right frontal lobe epilepsy (RFLE, n = 18), and left frontal lobe epilepsy (LFLE, n = 19). Patients with LTLE required 106.8 ± 93.7 seconds (range, 5 to 323 seconds) to recover consciousness during the postictal state and be able to respond to the cognitive and behavioral testing and with RTLE 60.9 ± 48.3 seconds (range, 7 to 239 seconds). Frontal lobe patients with left-sided lateralization needed 54.2 ± 66.6 seconds (range, 6 to 280 seconds) and with right-sided lateralization 68.6 ± 90.5 seconds (range, 8 to 342 seconds) to recover consciousness during the postictal state. In conclusion, left temporal lobe seizure onset can be used as a localizing indicator in the recovering process of consciousness during the postictal state, in temporal lobe epilepsy the duration is longer and in frontal lobe epilepsy the duration to respond is shorter.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Epilepsy, Epileptic Seizures, Consciousness in Epilepsy, Temporal Lobe Epilepsy, Frontal Lobe Epilepsy, Recovering of Consciousness, Ictal Semiology, Postictal Semiology, Aphasia in Epilepsy
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 4. Oktober 2021
• 1. Bericht­erstatter:in: Pöppel, Ernst