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Prophylaxis or treatment of tumor-associated seizures is adaily concern in neurosurgical practice but is often guided by the surgeon's habits rather than evidence from clinical trials, which is lacking. The present study reviews the literature on the incidence, clinical aspects and treatment of epilepsy and epileptic seizures in patients undergoing surgery for meningioma. Based on the published data, we then performed a French nationwide survey of neurosurgeons' practices regarding perioperative management of meningioma-related epilepsy and epileptic seizures., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Psychogenic nonepileptic seizures (PNES) are paroxysmal attacks that can imitate epileptic seizures but do not have a neurological origin. There has been mounting interest these last few years to unravel psychological and neuronal factors that contribute to the development of PNES. The objective of this review is twofold. First, we examine recent contributions of clinical and researches studies to define the main features of PNES. Then, we focus on the possible link between changes in processing of emotional information and the onset of PNES. In this article, we identify promising directions for future research and argue that affective neuroscience may provide original findings to better understand this disease.

Electroencephalography allows the functional analysis of electrical brain cortical activity and is the gold standard for analyzing electrophysiological processes involved in epilepsy but also in several other dysfunctions of the central nervous system. Morphological imaging yields complementary data, yet it cannot replace the essential functional analysis tool that is EEG. Furthermore, EEG has the great advantage of being non-invasive, easy to perform and allows control tests when follow-up is necessary, even at the patient's bedside. Faced with the advances in knowledge, techniques and indications, the Société de Neurophysiologie Clinique de Langue Française (SNCLF) and the Ligue Française Contre l'Épilepsie (LFCE) found it necessary to provide an update on EEG recommendations. This article will review the methodology applied to this work, refine the various topics detailed in the following chapters. It will go over the summary of recommendations for each of these chapters and underline proposals for writing an EEG report. Some questions could not be answered by the review of the literature; in those cases, an expert advice was given by the working and reading groups in addition to the guidelines., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Psychogenic nonepileptic seizures are clinical events that mimic epileptic seizures but are not associated with electroencephalographic discharges. These seizures are seldom reported in children in the literature and could be misinterpreted as generalized tonicoclonic seizures. We report the case of a child, already treated for epilepsy, who presented at 8 years of age with several psychogenic seizures leading to pseudostatus epilepticus. After several hospitalizations, the diagnosis of pseudostatus was established on the basis of clinical semiology, lack of EEG abnormalities during the seizures, and a positive provocation maneuver, which elicited and blocked the manifestations. The clinical spectrum of psychogenic seizures is wide and it is particularly difficult to differentiate psychogenic seizures from epileptic seizures, especially when occurring in children, some of whom are already treated for epilepsy. Well-described clinical features can suggest the diagnosis of psychogenic seizure. It is important and necessary to make the diagnosis as soon as possible in order to rapidly begin appropriate treatment including psychotherapy. In fact, the long-term prognosis in children is better than in the adult population. Associated risk factors, such as anxiety as reported in the present case, have to be sought. Recognizing psychogenic seizures will thus avoid their fixation in the child's personality and the risk of inappropriate and escalating treatments leading to iatrogenic complications., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

During the past decade, a large amount of work on transcranial magnetic stimulation (TMS) has been performed, including the development of new paradigms of stimulation, the integration of imaging data, and the coupling of TMS techniques with electroencephalography or neuroimaging. These accumulating data being difficult to synthesize, several French scientific societies commissioned a group of experts to conduct a comprehensive review of the literature on TMS. This text contains all the consensual findings of the expert group on the mechanisms of action, safety rules and indications of TMS, including repetitive TMS (rTMS). TMS sessions have been conducted in thousands of healthy subjects or patients with various neurological or psychiatric diseases, allowing a better assessment of risks associated with this technique. The number of reported side effects is extremely low, the most serious complication being the occurrence of seizures. In most reported seizures, the stimulation parameters did not follow the previously published recommendations (Wassermann, 1998) [430] and rTMS was associated to medication that could lower the seizure threshold. Recommendations on the safe use of TMS / rTMS were recently updated (Rossi et al., 2009) [348], establishing new limits for stimulation parameters and fixing the contraindications. The recommendations we propose regarding safety are largely based on this previous report with some modifications. By contrast, the issue of therapeutic indications of rTMS has never been addressed before, the present work being the first attempt of a synthesis and expert consensus on this topic. The use of TMS/rTMS is discussed in the context of chronic pain, movement disorders, stroke, epilepsy, tinnitus and psychiatric disorders. There is already a sufficient level of evidence of published data to retain a therapeutic indication of rTMS in clinical practice (grade A) in chronic neuropathic pain, major depressive episodes, and auditory hallucinations. The number of therapeutic indications of rTMS is expected to increase in coming years, in parallel with the optimisation of stimulation parameters., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Transient Epileptic Amnesia is a late-onset form of temporal lobe epilepsy characterized by recurrent attacks of transient retrograde and anterograde amnesia usually lasting less than one hour and beginning in late-middle to old age. Attacks commonly occur on waking, a potentially helpful diagnostic clue. The amnesic attacks may be associated with persistent memory complaints. The diagnosis is made on the basis of the clinical history, wake or sleep - deprived EEG (often repeated) and/or a clear - cut response to anticonvulsivant therapy. The pathophysiology remains poorly understood. It is uncertain whether recurrent episodes of amnesia represent ictal or post-ictal phenomena.

Astasia-abasia is defined as the inability to stand and to walk, despite sparing of motor function underlying the required balance and gestures. Initially, astasia-abasia was considered a psychogenic gait disorder, but later on, the description of "high-order" gait disorders mimicking this pure functional deficit led authors to refer to "astasia-abasia" as a pure descriptive term, without a presupposed etiological or anatomical substrate. In this paper, the main clinical characteristics of both psychogenic and non-psychogenic astasia-abasia are presented and discussed., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

Transient global amnesia (TGA) is characterized by a severe disturbance of memory, occurring rapidly, lasting less than a day and mainly affecting elderly subjects. During its acute phase, it is characterized by a severe anterograde amnesia, partial retrograde amnesia and anxiety with repetition of the same questions. The diagnosis is purely based on patient's clinical features. Complimentary examinations are only requested when atypical symptoms are present. The pathophysiology of TGA remains unknown, but it appears to be related to transient disturbances of the perfusion and oxygenation of the hippocampal structures, following a precipitating factor (stress, effort...). Spontaneous recovery is usual in less than 24 hours and without sequelae. Relapse is rare. Nevertheless, TGA represents a psychological traumatism pathology for the patients and their family.

The surgical treatment of intractable epilepsies involving eloquent areas of the cortex is still challenging. Deep-brain stimulation could be an alternative to resective surgery because it can modulate the remote control systems of epilepsy, such as the thalamus and basal ganglia. The surgical experience acquired in the field of movement disorder surgery and the low morbidity of this technic could allow one to apply DBS to intractable epilepsies, such as generalized, motor and bitemporal epilepsies. Here we discuss the main experimental and clinical data reported so far in the literature and taken from our own experience.

Introduction: The term of "migralepsy" has been proposed to define migraine-triggered epileptic seizures. Although already reported in the literature for more than fifty years, a number of observations remain debatable because of possible confusion between migraine and epileptic seizure clinical manifestations, including hemifield visual hallucinations, digestive signs and severe headache., Observation: We report on the case of a young patient suffering from both diseases, in whom a visual aura preceded either migraine attacks or epileptic generalized tonic-clonic seizure. Subtle modification in the primitive visual hallucination, which suddenly contained colored figures and was accompanied by fear before a prolonged loss of contact, suggested a continuum between migraine aura and epileptic seizure in this patient. Brain MRI was normal and EEG showed some sharp waves in the right posterior area., Conclusion: The presence of a neurophysiological continuum between migrainous aura and epileptic seizure is supported by this observation of "migralepsy". Recent findings from genetic and epidemiological studies further support this link.

Seizures and status epilepticus may be an early (<7-14 days) or late (>14 days) complication of acute stroke. Epilepsy, defined by at least two unprovoked epileptic seizures, may also be a late complication. Several risk factors have been identified for early and late seizures. Early seizures are more frequent in severe and disabling ischemic strokes, hemorrhagic strokes and those with cortical involvement. The risk of epilepsy is higher for patients with early seizures or cortical infarctions and in severely handicapped patients. Overall, approximately 4% of patient with an acute stroke will have at least one seizure in the early or late period, and half of them will develop epilepsy. Neither early nor late seizures appear to have a significant impact on mortality, although status epilepticus remains a life-threatening and often fatal event. The decision whether to start antiepileptic treatment after a first seizure or wait for a recurrence remains controversial. Risk of drug interactions and adverse effects in stroke patients must be kept in mind when prescribing antiepileptic drugs.

Oxytocin is required for lactation by promoting milk expulsion. Oxytocin has also been reported to exert a positive role in social attachment. The postpartum period has been shown to be crucial for maternal behavior initiation, and required self-trust reinforcement. However, this period is also remarkable for the high risk exposure of either psychic or physical stress. A negative impact on young mother is suspected, both in the short, medium or long term, which can even be deleterious for child-mother relationships. During lactation in female rats and sheep, oxytocin production has been proved to decrease stress-induced hormonal changes and later consequences. In human beings, only the first hour after breast-feeding seems to protect against physical or psychic stress. Oxytocin improves the stress-induced response by reducing the ACTH and cortisol secretion thus representing a potential therapeutic pathway in post-partum pathologies such as depression. Thus, this review of recent literature about oxytocin and stress during post-partum period, leads to the assumption that oxytocin, at the moment of installation of breastfeeding, acts not only on the physiological condition, but also on the psychic condition of the mother.

In a young woman presenting with severe coma, the EEG helped diagnosing baclofen overdose. In this patient, the first EEG showed continuous multifocal pseudoperiodic sharp waves. The diagnosis was confirmed by the plasma dosage providing an 8-fold increase above normal baclofen therapeutic range. Following symptomatic therapy, the patient improved within a few days and the EEG normalised. Few other drugs may be responsible for such EEG changes, namely lithium, cephalosporin, and bismuth. In such cases, EEG contribution to the diagnosis should not be ignored.

Introduction: The boundary between epilepsy and paroxysmal dyskinesia appears to be less easy to delineate than previously believed. Reports of families showing both phenomena suggest a shared pathophysiology., Patients and Method: A new family with autosomal dominant exercise-induced paroxysmal dystonia is reported., Results: Two family members also had childhood absence epilepsy, and one of them suffered from acute transient hemiplegia at age 10., Conclusion: The association of epilepsy and paroxysmal dyskinesia has been rarely reported in the literature, and several loci have been identified. Absence epilepsy and exercise-induced paroxysmal dystonia appear to be very uncommon, although some reports mentioned the association in sporadic and familial cases. The involvement of ion channel genes in several transient neurological disorders supports the hypothesis of a common pathophysiological process underlying both the childhood absence seizure and the later paroxysmal dystonia.

Drug-resistance is widely considered as a prerequisite for any surgical treatment in epilepsy. It is however noteworthy that an international consensus regarding the definition of this pharmacological concept, or, at least, detailing the criteria required for the diagnosis, is lacking. Based on a systematic review of the literature, we discuss the proposed definitions in expert's position papers or used in controlled or multicentric studies. A check-list for the diagnosis of drug-resistant epilepsy is proposed.

Eligibility criteria for surgical treatment in drug-resistant partial epilepsy are defined by the clinical and laboratory elements which favored the initiation of often costly and sometimes invasive investigations performed to determine the patient's operability. These criteria, which require a multidisciplinary team including a neurosurgeon, a neurophysiologist and a neurologist, must be distinguished from the operability criteria used by expert centers. Theoretically, eligibility criteria must be validated in terms of both sensitivity (capability to detect good candidates for surgery among the epileptic population) and specificity (exclusion of false candidates). Up to now, such validation of eligibility criteria has been lacking. The present systematic literature review examines the criteria currently used in controlled and multicentric studies, and the criteria which proved to be useful in determining outcome. This last set of criteria is theoretically a good candidate for future validation studies.

As long as the concept of dystonia, as currently defined and used, will encompass both a clinical syndrome, a genetic disease and a distinct clinical sign, rating scales devoted to dystonia will be facing a tremendous heterogeneity of phenomenology, including patients suffering from a very large spectrum of disease, exhibiting even contrasting features, namely, "mobile" dystonia as opposed to fixed postures. Indeed, relatively few clinical rating scales have been proposed in the evaluation of dystonia. This review constitutes an attempt to evaluate the position, in terms of reliability, pertinence, and usefulness of each of them. Since the worldwide diffusion of videotape recordings as a useful tool in the diagnosis and evaluation of Movement Disorders, scales have been developed aimed to yield a quantitative approach allowing the measurement of various therapeutic trials. In the setting of generalized dystonia, BFM and UDRS scales have been proposed, both of them being currently used. A recent study evaluating the clinimetric properties of these scales confirmed their usefulness in the setting of therapeutic trials. However, it is suggested that only a new scale, based on a two-axis analysis of dystonia, would be able to score both the "fixed posture" part and the "mobile" part of the so-called "dystonic" phenomenon.

Unlabelled: Inner speech is the little voice in the head which comments on everyday life activities. To some aspect, trouble in monitoring the inner speech has been regarded as relevant in auditory hallucinations in psychosis. Another disorder that may involve inner speech is the difficulty inhibiting its vocal utterance (the so-called verbal impulsion ). Verbal impulsion is a classic feature of Gilles de la Tourette's syndrome, during which patients complain of difficulties inhibiting socially undesirable behaviors, especially vocalization (i.e. coprolalia). In a previous paper, we reported on a patient with frontotemporal dementia, whose pathology was revealed by a difficulty inhibiting the verbal utterance of reading (inability to read silently). Later in the course of the disorder, the patient exhibited a severe frontal lobe syndrome with compulsive activities and coprolalia. Externally triggered inner speech has been proposed by the author to be represented by silent reading. In this setting, loss of silent reading can be regarded as the equivalent of a loss of control of the verbal utterance of the inner speech., Cases Report: In the present paper, a loss of control of inner speech is suggested as partly involved in two cases of Gilles de la Tourette's syndrome with coprolalia. Two adult patients with a diagnosis of Gilles de la Tourette's syndrome since age 7 and 10, respectively, have been asked to comment on their present or previous abilities to read silently. The first case never silent read as a child while the second case read silently but had a tendency to move his lips., Discussion: The frequency of observed difficulties in silent reading is likely to be a function of the age at which the subject is asked about such difficulties. Nevertheless, theoretical arguments are presented in this part of the paper which suggest that silent reading, considered as a way to challenge the control of inner speech, has been variably impaired at different stages of the disease. The author speculates that the key role of prefrontal cortex, especially the orbito-frontal areas, in the inhibitory control of current behavior, can be responsible for the deficit in the control of inner speech. In this setting, recent functional brain imaging performed in patients with Gilles de la Tourette's syndrome showed a striking deficit in the activation of these areas during tics. It would be of great interest to address this specific question in determining the frequency of difficulties in silent reading in Gilles de la Tourette's syndrome individuals as compared to those without Gilles de la Tourette's syndrome. In this way, the so-called Stroop-test should be adequate in addressing this pivotal issue. In this well-known neuropsychological test the subject is asked to orally report the color in which the name of color has been written. The discrepancy between the color of the written word and the name of the color that have been read can challenge the ability of the subject to correctly inhibit the reading (in example the word blue ) in order to say another color (in example red , if the word blue is red colored)., Conclusion: Loss of silent reading observed in such patients is suggestive of the failure of the prefrontal inhibitory control on the verbal utterance of inner speech. Further research is needed to confirm these findings.

Myoclonus, defined as shock-like involuntary movement, may be physiological or caused by a very wide variety of hereditary and acquired conditions. Because myoclonus can originate from different disorders and lesions affecting quite varied levels of the central and peripheral nervous systems, it represents from many points of view a diagnostic challenge. Moreover, new entities have been recently individualized, such as cortical tremor, which deserve renewed attention. The aim of this review is to propose a rationale for a diagnostic approach based on clinical and electrophysiological grounds. In this setting, we successively address 1) the clinical features allowing a positive diagnosis of myoclonus; 2) the clinical clues to the etiology; 3) the relevance of the clinical context to the diagnosis; and 4) the contribution of neurophysiology. Differentiating myoclonus from tics, spasm, chorea and dystonia can be difficult, and a careful reappraisal of clinical features allowing precise identification is presented. Moreover, the topographical distribution of myoclonus, the temporal pattern of muscle recruitment, the condition of occurrence and the rhythm of the event, may provide clinical clues relevant to the diagnosis. Myoclonus without associated epilepsy, myoclonus with epilepsy, myoclonus with encephalopathy, parkinsonism and/or dementia represent overlapping clinical categories, although they remain useful for the diagnostic approach. Using electrophysiology (including back-averaging EEG, MEG, SEP, C-reflex studies) to determine the origin of myoclonus may not allow us to focus on the underlying condition. Indeed, in many instances, the myoclonus is cortical in origin, but the pathology is found elsewhere.

This paper reviews the validity of clinical diagnostic criteria developed for Parkinson's disease and parkinsonian syndromes. Proposed criteria are predominantly empirical. There are only a few studies with neuropathological verifications. For Parkinson's disease and Progressive Supranuclear Palsy clinicopathological studies have been performed and led to pathologically based criteria. In this context, the specificity and sensitivity of clinical criteria could be assessed. Reliability however has seldom been tested. In contrast, the proposed criteria for the clinical diagnosis of Multiple System Atrophy and Corticobasal atrophy have not been pathologically evaluated.