Abstract Details

Title Clinical, Electroencephalographic and Neuroimage Findings of Patients with Cerebellar Ataxia and Epilepsy

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-003

Objective To describe phenotypical, imaging and neurophysiological features of patients affected by cerebellar ataxia and epilepsy.

Background The association of epilepsy with hereditary cerebellar ataxia is an emerging issue that has raised interest among researchers in the fields of movement disorders, epilepsy and neurogenetics, particularly the characterization of clinical and neurophysiological findings of affected patients. Although there are thorough descriptions of clinical and electroencephalographic findings of some diseases (such as SCA10 and progressive myoclonic epilepsies), there are no studies that accomplish a systematic correlation of clinical features, EEG and neuroimaging findings as a group of diseases.

Design/Methods 30 patients from southern Brazil diagnosed with both cerebellar ataxia and epilepsy were retrospectively assessed regarding specific diagnosis, clinical characteristics (severity, disease duration, seizure type and frequency), EEG and neuroimaging findings. Patients were also divided in 3 groups: autosomal dominant ataxias (SCAs), recessive ataxias and progressive myoclonic epilepsies and the findings were compared between those groups.

Results The most common diagnosis in each group was SCA10, undefined recessive ataxia and Unverricht Lundborg disease, respectively. A higher severity of ataxia symptoms (SARA rating scale) and worse seizure frequency control was found in patients with progressive myoclonic epilepsies. In 62%, seizure onset was determined to be generalized, with a higher frequency of tonic-clonic seizures. EEG analysis showed higher prevalence of epileptiform activity in the recessive ataxia group (57%, p<0.005). 80% of patients presented cerebellar atrophy on brain MRI, being the isolated abnormal finding in 56%.

Conclusions

The heterogeneity of the diseases that present cerebellar ataxia and epilepsy can be challenging. Higher frequency of SCA 10 was expected in the AD group, although in the southern Brazilian cohort this is the exception. PME ataxia was more severe and seizure control was poorer, compared to other groups. The results highlight the need for better characterization of epileptic ataxic patients and syndromes.

Authors/Disclosures
Emanuel Cassou, MD (Clinical Hospital of the Federal University of Parana) PRESENTER	Dr. Cassou has nothing to disclose.
Luciano De Paola, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
Quratulain Zulfiqar Ali (Toronto Western Hospital)	No disclosure on file
	No disclosure on file
Danielle M. Andrade, MD (University of Toronto)	The institution of Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceutical. The institution of Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke Therapeutics. The institution of Dr. Andrade has received research support from Epilepsy Canada. The institution of Dr. Andrade has received research support from SynGAP Research Fund. Dr. Andrade has received publishing royalties from a publication relating to health care. Dr. Andrade has a non-compensated relationship as a Former Chair of task force on Transition with International League Against Epilepsy that is relevant to AAN interests or activities. Dr. Andrade has a non-compensated relationship as a President with Canadian League Against Epilepsy that is relevant to AAN interests or activities.
Helio Afonso G. Teive, MD, PhD, FAAN	Dr. Teive has nothing to disclose.

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