Review article
https://doi.org/10.20471/acc.2021.60.s3.03
Posterior cortex seizures – pediatric challenges
Maša Malenica
orcid.org/0000-0003-4950-9038
; Division of Child Neurology, Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Faculty of Teacher Education, University of Zagreb, EpiCARE Croatia, Zagreb, Croatia
Monika Kukuruzović
; Division of Child Neurology, Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Faculty of Teacher Education, University of Zagreb, EpiCARE Croatia, Zagreb, Croatia
Iva Šeparović
; Division of Child Neurology, Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Faculty of Teacher Education, University of Zagreb, EpiCARE Croatia, Zagreb, Croatia
Dunja Čokolić Petrović
; Department of Pediatrics, Osijek University Hospital Centre, Osijek, Croatia
Abstract
Posterior cortex seizures have a complex semiologic presentation that is especially
challenging in the pediatric population. Therefore, using clinical presentation in localizing ictal involvement
is not sufficient in children, thus making this type of epilepsy quite under-recognized. As
most of the ictal symptoms are subjective and could well be overshadowed by symptoms arising from
adjacent cortices, primarily temporal and central ones, it is necessary not to overlook this large source
of pharmacoresistant epilepsies. The parietal lobe as part of an extensive synaptic network is a great
imitator, thus quite often producing inaccurate localization readings on scalp electroencephalography
(EEG) due to very scattered interictal discharges and uninformative ictal recordings. Using direct
cortical recordings in delineating the epileptogenic zone is helpful in some cases but even highly experienced
epileptologists may erroneously interpret some features as arising from other localizations,
especially the frontal lobe. Epilepsy surgery from the posterior quadrant is still quite rare and relatively
unsuccessful, especially in non-lesional epilepsies due to elaborate mechanisms of connectivity,
misleading semiology, and non-localizing EEG recordings, possibly due to insufficiency of parietal
cortex synchronicity. Applying the aforementioned to the pediatric age makes it perhaps the most
difficult challenge for a pediatric epileptologist.
Keywords
Posterior cortex epilepsy; Semiology; Pediatric epilepsy; Epilepsy surgery; Connectivity
Hrčak ID:
285125
URI
Publication date:
31.12.2021.
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