Startle epilepsy: clinical characteristics, EEG pattern and surgical treatment

Objective To study the clinical,scalp and intracranial electroencephalogram (EEG) characteristics of startle epilepsy,and its outcome of surgical treatment.Methods The clinical data of 9 patients with startle epilepsy who were treated in our hospital were reviewed retrospectively.Their scalp and intracranial EEG,and MRI were investigated.Results All of the patients were diagnosed as startle epilepsy,and most of seizures were provoked by sudden unexpected stimuli.MRI showed extensive lesions in 8 cases,scalp EEG showed mulifocality or focal epilepsic discharge in all.Intracranial electrodes monitoring were performed in 2 patients to locate the epileptogenic zone.Five patients were treated surgically,3 of them were operated with hemispherectomy,and 2 with focal cortex resection.During 6 -30 months follow up,the seizure outcome were Engel Ⅰ grade in 4,and Engel Ⅲ grade in 1.Conclusions Most of the patients with startle epilepsy has brain lesions involving the perisensorimotor or supplementary sensorimotor area,and were refractory.Resective surgery may get satisfactory outcome. Key words: Startle epilepsy ;  Surgical procedures,operative ;  Sensorimotor area ;