Search

Competing Interests: Declaration of Competing Interest All authors declare that there is no conflict of interest.

Purpose: To delineate chronological changes of cortical hyperexcitability by long-term follow-up of the amplitudes of somatosensory evoked potentials (SEPs) in patients with Japanese Unverricht-Lundborg disease (ULD)., Method: SEPs to median nerve stimulation were repeatedly examined in 7 genetically diagnosed ULD patients with the mean interval of 11.9 years. The degree of temporal changes in the amplitude of 3 early cortical components, N20, P25 and N35, to the age was analyzed and compared with that of healthy subjects., Results: Their clinical course was almost stable during the follow-up period, namely cessation of generalized tonic-clonic seizures and little or no progression of myoclonus. SEP amplitudes of P25 and N35 were enlarged in all patients and were gradually decreased with aging in ULD on average. The degree of temporal changes of P25 and N35 in ULD was similar or even lower than that of healthy subjects., Conclusion: Enlarged but relatively stable SEP amplitudes had a consistency with so-called self-limited clinical course in Japanese ULD. SEP amplitude could be one of the surrogate markers of the degree of cortical hyperexcitability in ULD during the long-term follow-up period., (Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Objective: To delineate long-term change of cortical excitability by measuring somatosensory evoked potentials (SEPs) in patients with Unverricht-Lundborg disease (ULD)., Methods: SEPs to median nerve stimulation were repeatedly examined in two genetically proven ULD patients manifesting stable condition over 16 years, namely disabling but non-progressive myoclonus and cessation of generalised tonic-clonic seizures., Results: In both patients, five sets of early cortical components were identified 16 years ago: two tangential components of N20-P20 and P30-N30 and three radial components of P25, N35 and N40. Cortical SEPs were regarded as abnormally enhanced 'giant' based on the N35 amplitude (>mean+3 SD of normal controls). The bimodal negative peaks of N35 and N40 showed different spatial distribution: N35 maximum in the central area and N40 in the centro-parietal area. At present, N35 remained giant while N40 disappeared in both patients., Conclusions: It is possible that currently preserved giant SEPs at least at N35 reflect disabling cortical myoclonus and that disappearance of N40 might reflect a lesser degree of increased cortico-cortical connectivity and/or decreased cortical hyperexcitability in the association cortices. It might possibly have resulted in the disappearance of GTCSs., Significance: We delineated long-term change of giant SEP in ULD., (Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)