ArticleAnnals of neurology2024
Ictal Central Apnea Is Predictive of Mesial Temporal Seizure Onset: An Intracranial Investigation.
Article in Annals of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Ictal and postictal central apnea: Integrating pathophysiological mechanisms with SUDEP risk stratification.Epileptic disorders : international epilepsy journal with videotape · 2026Article
- Prolonged ictal and post-ictal central apnea in an epileptic seizure.Epileptic disorders : international epilepsy journal with videotape · 2026Article
- Response to: Ictal and postictal central apnea: Integrating pathophysiological mechanisms with SUDEP risk stratification.Epileptic disorders : international epilepsy journal with videotape · 2026Article
- The bed nucleus of the stria terminalis as a neuromodulatory target for refractory epilepsy.Frontiers in network physiology · 2026Review
- Peri-ictal respiratory dysfunction: Expanding the association between mTOR pathway disorders and ictal central apnea.Epilepsia · 2025Article
- Risk markers for sudden unexpected death in epilepsy: an observational, prospective, multicentre cohort study.Lancet (London, England) · 2025Observational
- Persistent Postictal Central Apnea in Focal Seizures: Incidence, Features, and Imaging Findings.Neurology · 2025Article
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveIctal central apnea (ICA) is a semiological sign of focal epilepsy, associated with temporal and frontal lobe seizures. In this study, using qualitative and quantitative approaches, we aimed to assess the localizational value of ICA. We also aimed to compare ICA clinical utility in relation to other seizure semiological features of focal epilepsy.
methodsWe analyzed seizures in patients with medically refractory focal epilepsy undergoing intracranial stereotactic electroencephalographic (SEEG) evaluations with simultaneous multimodal cardiorespiratory monitoring. A total of 179 seizures in 72 patients with reliable artifact-free respiratory signal were analyzed.
resultsICA was seen in 55 of 179 (30.7%) seizures. Presence of ICA predicted a mesial temporal seizure onset compared to those without ICA (odds ratio = 3.8, 95% confidence interval = 1.3-11.6, p = 0.01). ICA specificity was 0.82. ICA onset was correlated with increased high-frequency broadband gamma (60-150Hz) activity in specific mesial or basal temporal regions, including amygdala, hippocampus, and fusiform and lingual gyri. Based on our results, ICA has an almost 4-fold greater association with mesial temporal seizure onset zones compared to those without ICA and is highly specific for mesial temporal seizure onset zones. As evidence of symptomatogenic areas, onset-synchronous increase in high gamma activity in mesial or basal temporal structures was seen in early onset ICA, likely representing anatomical substrates for ICA generation.
interpretationICA recognition may help anatomoelectroclinical localization of clinical seizure onset to specific mesial and basal temporal brain regions, and the inclusion of these regions in SEEG evaluations may help accurately pinpoint seizure onset zones for resection. ANN NEUROL 2024;95:998-1008.
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