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electroclinical syndrome

ICD-10 Codes

Related ICD-10:

I51.5 G90.5 I49.40 I69.992 G25.1 H55.0 Q21.8 Q93.52 A52.15 A81.0 B46.1 A80.30 N04.4 I45 P91.819 A52.11 I49 R25.0 G57.13 I69.318 M04.2 S06.1X5 P29.12 E75.23 Q07.01 G04.91 G25.8 G25.83 G40.A0 S14.154 A33 G71.0340 I69.214 G37.3 H55.89 I69.26 G57.6 I69.369 G40.31 G54.5 G40.841 I49.0 G20.A1 Q86.1 G61.0 S24.131 G12.21 H52.53 Q21.14 Z22.340 G43.6 G43.61 I97.0 G21.11 G83 I69.262 O21.1 G04.32 G45.0 O26.4 P28.2 S24.133 G72.81 I67.850 I69.25 I69.253 I69.254 S14.128 G43.019 K31.1 G23 S06.38 G90.529 Q07.0 S06.37 G04.0 S14.11 S14.116 I63.51 E76.21 G51.3 G51.32 O14.1 R29.1 G43.011 I44.60 F44.6 H47.23 I65.03 R45.1 G43.4 H02.511 G44.009 A50.03 K59.81 G04.3 T79.1 Q87.84 E26.81 G11.11 G10 G90.4 M89.042 M34.1 I69.812 S06.0XA G40.119 I44.5 S06.1X7 A36.82 I69.361 G11.2 S06.1X4 S06.5X6 I63.132 G90.1 A50.04 T36.5X5 I67.81 L28.1 M89.032 M54.81 S14.131 G46.6 T79.A12 F20.2 I69.019 Q80.4 S06.31A E75.4 D86.85 G43.81 S06.324 G93.7 G46.1 R94.09 Q76.1 E79.2 P11.9 S14.138 I74.8 E51.2 G43.811 H53.16 G44.019 B02.23 L98.2 A50.45 G70.80 T43.015 E71.314 S14.126 H60.21 H49.813 I23.7 A50.39 G90.89 E75.25 T71.231 R39.14 G40.11 G40.111 F45.0 E71.541 P74.32 I69.954 I48.21 I69.213 I63.323 H57.051 G82.54 I82.C A52.16 M31.31 A81.89 H50.18 G93.81 G82.50 A52.04 I63.522 G12.23 L40.1 I63.39 Q06.0 K55.032 G23.2 O14.24 I69.165 S14.139 S06.326 E75.27 E75.243 A81.83 I69.911 E88.49 T42.0X5 S14.135 H02.514 S06.317 G25.82 G24.2 H50.81 G81.04 I69.310 D59.30 G57.43 I63.11 P10.4 G90.2 G40.A09 G65.0 G83.4 S06.329 A69.22 G37.4 H02.51 M61.2 A88.1 E78.72 G61.81 S14.147 G40 G44.03 I49.49 H81.4 I69.321 T42.3X2 K55.031 H90 H90.A E75.21 K50.014 G37.89 B02.24 E75.28 G81.11 I69.011 S34.12 G40.802 G93.89 I69.22 O89.3 G46.0 E72.03 I45.10 B02.22 H47.611 A39.1 P27.0 G90.511 P91.823 G40.814 M47.013 F84.2 G95.0 S06.5X2 S14.137 S34.112 I67.83 I44.2 I69.814 G31.81 I63.549 Q93.51 H83.2 G40.91 S24.134 E67.2 M07.6 A80.2 G35 G47.419 T85.0 B06.02 Q87.83 A50.40 I69.319 E87 H51.21 H80.1 I69.363 R29.81 G70 M89.062 G71.035 G23.1 G40.209 E71.310 I69.332 Q34 J95.4 G25.71 G40.834 G71.228 G83.1 S06.0X9 F45 H02.516 G43.619 S34.0 G40.822 H47.14 G40.80 I69.83 G40.00 H81.11 H93.2 H50.811 P28.41 G40.811 G57.82 H66.3X I63.2 G80.1 I69.053 P14.1 I63.529 S06.377 G40.509 G51.0 I26.02 I69.33 M76.811 G03.2 P11.0 O29.9 S24.139 E24.1 R40.231 S06.372 S06.0X G44.0 H81.393 R40.243 S34.121 H49.03 P94.0 I49.02 I69.349 S06.0X1 F10.232 I69.16 I69.359 S14.156 G51.2 I45.1 I97.19 T44.0X4 I69.96 O15.2 T40.992 H02.23 D86.82 P02.7 G40.3 M96.89 G47.421 E71.111 G43.B I63.6 I63.81 G73.1 G83.9 M35.1 S14.121 D61.02 E05.80 G83.82 I69.328 T38.3X A50.49 I63.29 I69.251 Q87.11 H18.81 R94.130 I69.219 Q05.3 T83.590 G50.1 G71.220 G40.C09 L51.3 S24.154 F95.2 I44 I44.4 G83.81 H49.4 I01.0 G82.21 I69.953 A32.12 F84.0 G57.0 S14.136 T69 G11.6 M60 G31.01 S06.1X2 G44.51 Q74.3 A50.53 S24.114 G40.30 G12.25 I30.0 I69.261 R29.717 S14.146 R40.211 B26.1 E83.01 Q07 E03.5 H51.23 H83.2X G40.B19 Q04 G04.30 I63.43 M31.5 A79.0 G25.89 I82.C23 T88.3 M62.221 D59.31 O14.25 S06.5X3 H92.02 F44.1 S06.2X5 G40.0 O15 G47.10 I63.413 G71.12 I63.532 H49.0 G56.40 I69.343 E71.312 E71.511 Q75.058 I69.341 G04.1 G40.011 B57.49 G70.2 G71.22 E72.51 R94.31 H49.3 H81.1 G43.009 G45.4 I21.01 B00.82 G51.31 T71.234 S06.320 G43.5 E76.01 I63.322 G82.53 G51.9 S34.123 H70.203 S34.01 M47.011 R15.9 G90.3 P29.81 F78.A1 G40.844 O14.23 H93.3 Q07.02 T71.131 I69.231 G37.0 H47.612 I69.865 S34.111 I49.01 T85.190 M62.241 G44.09 I21.2 A81.8 G25.4 S06.4X1 A50.02 H80.12 H83.8X3 G51.33 A81.82 G40.81 G57.73 H02.515 G36 G36.1 H02.43 H30.03 G93.82 O14.2 O14.22 E88.41 M02.3 A50.56 G43.501 G43.519 G57.7 I69.365 S34.115 G40.419 G40.C1 G40.C19 I63.0 G40.90 G25.3 I46 I69.218 T85.11 H53.483 I48.4 F84.5 G81.0 G40.C11 A50.7 S06.5 E75.0 T85.731 G47.41 G23.0 T42.8X5 G40.823 T42.8 A80.39 E78.71 F06.1 G47.61 P57 U09 I69.854 I69.869 H53.42 G81.01 I69.344 A39.2 M35.06 G89.0 I69.215 R25.2 F44.89 H30.81 H30.812 I45.6 S06.5X9 G31.86 T46.995 S06.2X4 G83.84 I69.154 G40.319 I69.331 G71.034 H02.512 Q22.6 I69 F44.81 R29.810 H53.462 I69.913 I48.1 I48.11 S14.14 G04.39 I45.81 I44.6 I69.354 H91.03 S24.142 I69.352 S24.149 E71.52 S06.348 S14.112 S06.371 G58.7 A36.83 T45.5 P28.4 S14.149 G40.009 G46.7 S06.2X2 G60.1 H47.141 J05.11 I63.423 S26.01 I63.013 S54.2 T42.5X4 G40.813 Q43.1 R53.2 E74.04 T85.734 I69.961 I67.841 B02.21 P91.63 G24.4 G90.523 M62.262 S06.5X7 E79.81 M53.0 G90.B I69.834 P71.3 G72.3 R27.0 S14.124 I69.351 I69.86 G57.63 T42.75 I69.322 I47.0 G40.A19 S06.346 O62.4 G40.B0 G81.13 I69.364 G40.83 P29.11 R40.3 H15.05 M94.1 F44.2 G43.609 H50.15 I87.021 G40.409 P70.2 K55.061 O15.02 H47.149 I66.9 E71.540 G44.091 G96.89 G52.2 I69.010 E80.21 Q25.1 M89.07 G40.A G47.51 H49.81 F95.0 G71.13 G31.82 I44.1 R94.01 S24.0 T44.2X5 G36.0 I63.34 G40.89 G57.03 R94.131 G90.512 P93.0 S06.1X6 G61.9 G93.2 I69.013 K14.6 H90.7 G91.2 D81.5 I69.098 R07.81 G40.843 I73.0 I63.012 G24.09 E87.4 R40.213 G80.2 G44.021 H02.431 G40.C

Description

Electroclinical Syndrome: A Comprehensive Overview

An electroclinical syndrome (ECS) refers to a group of clinical entities that exhibit a characteristic cluster of electro-clinical characteristics, with a specific age of onset and types of seizures [3][5]. This concept is crucial in the diagnosis and management of various epilepsy syndromes, particularly in childhood.

Key Features

  • A syndrome defined as a characteristic cluster of clinical and electroencephalographic features, often supported by specific etiological findings [4][7]
  • A group of clinical entities showing a cluster of electro-clinical characteristics, with a specific age of onset and types of seizures [3][5]
  • Can be characterized by brief, simple focal hemifacial motor seizures with associated somato-sensory symptoms, which evolve into generalized seizures [6]

Clinical Presentation

The presentation of ECS can vary depending on the specific syndrome. However, common features include:

  • Affective symptoms: fear, terror, anger, rage, depression, extreme pleasure or displeasure [8]
  • Cognitive disturbances: forced thinking, dreamy states, distortion of time and space [8]

Importance in Epilepsy Diagnosis

ECS plays a significant role in the diagnosis and management of various epilepsy syndromes. Accurate identification of ECS can help clinicians to:

  • Develop targeted treatment plans
  • Predict seizure outcomes and recurrence rates
  • Provide patients and families with informed decision-making options

In conclusion, electroclinical syndrome is a complex concept that requires a comprehensive understanding of its clinical and electroencephalographic features. By recognizing the key characteristics and clinical presentation of ECS, clinicians can provide accurate diagnoses and develop effective treatment plans for patients with epilepsy.

References

[3] Name, electroclinical syndrome. Definition, An epilepsy syndrome that is a group of clinical entities showing a cluster of electro-clinical characteristics...

[5] by P Parisi · 2011 · Cited by 13 — Electro-clinical syndrome is a term used to identify a group of clinical entities showing a cluster of electro-clinical characteristics, with...

[4] by H Cross · 2023 — Electroclinical syndrome diagnosis remains central to this; a syndrome defined as a characteristic cluster of clinical and electroencephalographic features,...

[6

Additional Characteristics

  • A group of clinical entities showing a cluster of electro-clinical characteristics, with a specific age of onset and types of seizures
  • Can be characterized by brief, simple focal hemifacial motor seizures with associated somato-sensory symptoms, which evolve into generalized seizures
  • Accurate identification of ECS can help clinicians to: Develop targeted treatment plans, Predict seizure outcomes and recurrence rates, Provide patients and families with informed decision-making options

Signs and Symptoms

Electroclinical Syndromes (ECS) Signs and Symptoms

Electroclinical syndromes are a group of conditions characterized by specific patterns on an electroencephalogram (EEG) and corresponding clinical symptoms. The signs and symptoms of ECS can vary depending on the specific syndrome, but here are some common features:

  • Seizures: Seizures are a hallmark of ECS. They can be focal or generalized and may manifest as convulsions, muscle contractions, or changes in consciousness.
  • Autonomic Symptoms: Autonomic symptoms such as sweating, flushing, and heart rate changes are often associated with ECS (1).
  • Motor Symptoms: Motor symptoms include grunting, gurgling, guttural, and choking vocalizations that can bring the seizures to attention (6).

Some specific electroclinical syndromes and their signs and symptoms include:

  • Panayiotopoulos Syndrome: Characterized by seizures with predominantly autonomic symptoms and an EEG showing shifting and/or sharp waves (1).
  • Rolandic Epilepsy: Focal seizures consisting of unilateral facial sensory-motor symptoms are a cardinal feature of this syndrome (8).

References

(1) Parisi, P. (2011). Panayiotopoulos Syndrome: A Review of the Literature. [Cited by 13]

(6) Parakh and Katewa When there is no reference provided for this source.

(8) KOUTROUMANIDIS, M. (Cited by 137)

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies on electroclinical syndromes.

Additional Symptoms

  • Seizures
  • Autonomic Symptoms
  • Motor Symptoms
  • Panayiotopoulos Syndrome
  • Rolandic Epilepsy

Diagnostic Tests

Based on the provided context, it appears that there are several diagnostic tests associated with electroclinical syndromes.

Imaging Studies

  • Magnetic Resonance Imaging (MRI) of the brain is a crucial diagnostic tool to identify structural defects [2].
  • CT and MRI scans are also mentioned as part of the imaging services offered by CIS (Charlotte Radiology and Atrium Health joint venture) [11].

Electroencephalography (EEG)

  • EEG is a non-invasive technique used to measure underlying rhythms in the brain, both invasively and non-invasively [3].
  • Prolonged video-EEG monitoring is a useful tool in diagnosing neonatal-onset epileptic encephalopathies [8].

Genetic Investigations

  • Epilepsy gene panel testing can be used to evaluate the diagnostic yield of epilepsy patients whose seizures began within the first year after birth [7].
  • Genetic investigations, including microarray to identify copy-number variants and karyotype to diagnose conditions such as ring chromosome 20 syndrome, are also mentioned [9].

Other Diagnostic Tests

  • Blood ammonia and arterial blood gas metabolic profile can be obtained to look for structural defects [2].
  • Ultrasound is also mentioned as part of the imaging services offered by CIS [11].

It's worth noting that Quest Diagnostics Incorporated offers a range of diagnostic services, including CLIA certified laboratories that provide HIPAA covered services [10]. However, it's unclear if these services are directly related to electroclinical syndromes.

References:

[1] P Parisi (2011) - Cited by 13 [2] P Jain (2013) - Cited by 45 [3] Various studies (no specific reference) [4] U Seneviratne (2017) - Cited by 98 [5] RA Machado (2024) - No citation [6] P Parisi (2011) - Cited by 13 [7] SS Jang (2019) - Cited by 36 [8] AL Numis (2014) - Cited by 137 [9] S Pujar (2024) - Cited by 1 [10] Quest Diagnostics Incorporated (no specific reference) [11] CIS (Charlotte Radiology and Atrium Health joint venture) [11] [12] Novant Health Imaging Museum (no specific reference) [13] Carolinas Imaging Services (no specific reference) [14] Diagnostic Medical Sonography Program (no specific reference)

Additional Diagnostic Tests

  • Ultrasound
  • MRI
  • EEG
  • CT scan
  • Microarray
  • Prolonged video-EEG monitoring
  • Epilepsy gene panel testing
  • Karyotype
  • Blood ammonia test
  • Arterial blood gas metabolic profile

Treatment

Treatment Options for Electroclinical Syndrome

Electroclinical syndrome, also known as Lennox-Gastaut syndrome (LGS), is a rare and severe form of epilepsy characterized by multiple seizure types and developmental delays. While there are various treatment options available, the primary goal is to control seizures and improve quality of life.

  • Antiseizure medications: These remain the first-line treatment for LGS, with valproate being a commonly used medication [4]. Other effective add-on medications include lamotrigine, rufinamide, topiramate, and clobazam [4].
  • Ketogenic diet: This dietary therapy has shown positive outcomes in reducing seizure frequency and improving EEG background organization [3].
  • Epilepsy surgery: Surgical interventions can be considered for patients with focal seizures or those who have failed medical treatment. Surgery may involve resecting the affected area of the brain or implanting a vagus nerve stimulator.
  • Steroids and ACTH: Some studies suggest that steroids and adrenocorticotropic hormone (ACTH) should be considered as a first-line treatment, especially in early-onset cases [5].
  • Emerging treatments: Research is ongoing to develop new treatments for LGS. Agents such as fenfluramine and cannabidiol have shown promise but require further evaluation in randomized controlled trials [1][9].

It's essential to note that each patient with electroclinical syndrome is unique, and treatment plans should be tailored to individual needs. A multidisciplinary team of healthcare professionals, including neurologists, epileptologists, and psychologists, can provide comprehensive care and support.

References: [1] EC Wirrell (2016) - Several agents in development may show promise, specifically fenfluramine and cannabidiol, but they need further evaluation in randomized, controlled trials. [3] Antiseizure medications remain the first-line treatment, but ketogenic diet and epilepsy surgery have also shown positive outcomes and can decrease drug burden. [4] by A Verrotti (2018) - Despite many drugs available, valproate continues to have a role in the LGS treatment. Lamotrigine, rufinamide, topiramate, and clobazam are effective add-on medications. [5] by P Parisi (2011) - Some authors suggest that steroids and ACTH should be considered the treatment of choice especially in early onset of disease [116]. [9] EC Wirrell (2016) - Several agents in development may show promise, specifically fenfluramine and cannabidiol, but they need further evaluation in randomized, controlled trials.

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

The differential diagnosis of electroclinical syndromes involves identifying the underlying causes of a patient's symptoms and distinguishing them from other possible conditions.

According to search results, symptomatic cases of electroclinical syndromes can present different causes such as hypoxic-ischemic encephalopathy, vascular damage, perinatal meningoencephalitides, tuberous sclerosis, Down's syndrome, and others [1][2].

Each electro-clinical syndrome can be classified according to age at onset, cognitive and developmental antecedents and consequences, motor and behavioral manifestations, and other factors [3]. This classification can help in identifying the underlying causes of a patient's symptoms.

The EEG (electroencephalogram) provides important information about background EEG and epileptiform discharges and is required for the diagnosis of specific electroclinical syndromes [4].

In some cases, differential diagnosis may involve ruling out other conditions such as benign myoclonic epilepsy of infancy, ring chromosome 20 syndrome, mitochondrial cytopathies, organic acidurias, and others [5][6][9].

The 2017 ILAE Classification of the Epilepsies defined three diagnostic levels including seizure type, epilepsy type, and epilepsy syndrome. This classification can help in identifying the underlying causes of a patient's symptoms and making an accurate diagnosis.

To make an accurate differential diagnosis, it is essential to consider all possible causes of electroclinical syndromes and rule out other conditions through a thorough medical evaluation and diagnostic testing.

References: [1] P Parisi (2011) - Symptomatic cases present different causes such as hypoxic-ischemic encephalopathy, vascular demage, perinatal meningoencephalitides, tuberous sclerosis, Down's syndrome... [2] P Parisi (2011) - Each electro-clinical syndrome can be classified according to age at onset, cognitive and developmental antecedents and consequences, motor and behavioral manifestations... [3] P Parisi (2011) - Each electro-clinical syndrome can be classified according to age at onset, cognitive and developmental antecedents and consequences, motor and behavioral manifestations... [4] Feb 28, 2022 - The EEG provides important information about background EEG and epileptiform discharges and is required for the diagnosis of specific electroclinical syndromes. [5] Benign myoclonic epilepsy of infancy: electroclinical symptomatology and differential diagnosis from the other types of generalized epilepsy of infancy. [6] A Radhakrishnan (2012) - Ring chromosome 20 {r(20)} – manifests as a refractory epilepsy syndrome with complex partial seizures (CPS), nocturnal frontal lobe seizures and... [7] The 2017 ILAE Classification of the Epilepsies defined three diagnostic levels including seizure type, epilepsy type and epilepsy syndrome. [8] Seizures have traditionally been classified considering clinical and electroencephalographic manifestations into two main groups. [9] Jul 30, 2019 - Diagnostic Considerations · Anoxia · Benign epilepsy syndromes · Mitochondrial cytopathies · Myoclonic epilepsy · Myoclonus · Organic acidurias.

Additional Differential Diagnoses

  • Hypoxic-ischemic encephalopathy
  • Vascular damage
  • Perinatal meningoencephalitides
  • Benign myoclonic epilepsy of infancy
  • Ring chromosome 20 syndrome
  • Mitochondrial cytopathies
  • Organic acidurias
  • N syndrome
  • tuberous sclerosis 1

Additional Information

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