Epileptic DisordersVolume 8, Issue 1 p. 81-85 Debate Are epilepsy classifications based on epileptic syndromes and seizure types outdated? H.O. Lüders, Corresponding Author H.O. Lüders n/[email protected] Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA Correspondence: H.O. Lüders Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USASearch for more papers by this authorJ. Acharya, J. Acharya Epilepsy Center, St. Louis University, St. Louis, MO, USASearch for more papers by this authorA. Alexopoulos, A. Alexopoulos Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorC. Baumgartner, C. Baumgartner Department of Neurology, Medical University of Vienna, Vienna, AustriaSearch for more papers by this authorJ. Bautista, J. Bautista Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorR. Burgess, R. Burgess Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorM. Carreño, M. Carreño EEG and Epilepsy, Hospital Clinic, Barcelona, Barcelona, SpainSearch for more papers by this authorB. Diehl, B. Diehl Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorD. Dinner, D. Dinner Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorA. Ebner, A. Ebner Epilepsy Surgery Program, Bethel, Klinik Mara, Epilepsy Center, Bethel, Bielefeld, GermanySearch for more papers by this authorN. Foldvary, N. Foldvary Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorJ. Godoy, J. Godoy Departmento de Neurolgia, Universidad Católica De Chile, Santiago, ChileSearch for more papers by this authorH. Hamer, H. Hamer Epilepsy Center, University of Marbug, Marburg, GermanySearch for more papers by this authorA. Ikeda, A. Ikeda Comprehensive Adult Epilepsy Center, Kyoto University Hospital, Kyoto University, Kyoto, JapanSearch for more papers by this authorK. Källén, K. Källén Section of Epilepsy, Lund University Hospital, Lund, SwedenSearch for more papers by this authorC. Kellinghaus, C. Kellinghaus Epilepsy Centre, University of Münster, Münster, GermanySearch for more papers by this authorP. Kotagal, P. Kotagal Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorD. Lachhwani, D. Lachhwani Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorT. Loddenkemper, T. Loddenkemper Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorJ. Mani, J. Mani Neurologist, Mumbai, IndiaSearch for more papers by this authorR. Matsumoto, R. Matsumoto Comprehensive Adult Epilepsy Center, Kyoto University Hospital, Kyoto University, Kyoto, JapanSearch for more papers by this authorG. Möddel, G. Möddel Epilepsy Centre, University of Münster, Münster, GermanySearch for more papers by this authorD. Nair, D. Nair Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorS. Noachtar, S. Noachtar Epilepsy Center Munich, University of Munich, Munich, GermanySearch for more papers by this authorC.A. O'Donovan, C.A. O'Donovan Comprehensive Epilepsy Center, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USASearch for more papers by this authorS. Rona, S. Rona Epilepsy Center, University of Freiburg, Freiburg, GermanySearch for more papers by this authorF. Rosenow, F. Rosenow Interdisciplinary Epilepsy Center, University Hospitals, Philipps University, Marburg, GermanySearch for more papers by this authorS. Schuele, S. Schuele Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorC.A. Szabo, C.A. Szabo South Texas Comprehensive Epilepsy Center, University Texas Health Science Center at San Antonio, San Antonio, TX, USASearch for more papers by this authorN. Tandon, N. Tandon Epilepsy Surgery, Dept of Neurosurgery, University of Texas Health Science Center - Houston, Houston, TX, USASearch for more papers by this authorA. Tanner, A. Tanner Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorP. Widdess-Walsh, P. Widdess-Walsh Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this author H.O. Lüders, Corresponding Author H.O. Lüders n/[email protected] Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA Correspondence: H.O. Lüders Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USASearch for more papers by this authorJ. Acharya, J. Acharya Epilepsy Center, St. Louis University, St. Louis, MO, USASearch for more papers by this authorA. Alexopoulos, A. Alexopoulos Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorC. Baumgartner, C. Baumgartner Department of Neurology, Medical University of Vienna, Vienna, AustriaSearch for more papers by this authorJ. Bautista, J. Bautista Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorR. Burgess, R. Burgess Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorM. Carreño, M. Carreño EEG and Epilepsy, Hospital Clinic, Barcelona, Barcelona, SpainSearch for more papers by this authorB. Diehl, B. Diehl Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorD. Dinner, D. Dinner Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorA. Ebner, A. Ebner Epilepsy Surgery Program, Bethel, Klinik Mara, Epilepsy Center, Bethel, Bielefeld, GermanySearch for more papers by this authorN. Foldvary, N. Foldvary Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorJ. Godoy, J. Godoy Departmento de Neurolgia, Universidad Católica De Chile, Santiago, ChileSearch for more papers by this authorH. Hamer, H. Hamer Epilepsy Center, University of Marbug, Marburg, GermanySearch for more papers by this authorA. Ikeda, A. Ikeda Comprehensive Adult Epilepsy Center, Kyoto University Hospital, Kyoto University, Kyoto, JapanSearch for more papers by this authorK. Källén, K. Källén Section of Epilepsy, Lund University Hospital, Lund, SwedenSearch for more papers by this authorC. Kellinghaus, C. Kellinghaus Epilepsy Centre, University of Münster, Münster, GermanySearch for more papers by this authorP. Kotagal, P. Kotagal Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorD. Lachhwani, D. Lachhwani Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorT. Loddenkemper, T. Loddenkemper Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorJ. Mani, J. Mani Neurologist, Mumbai, IndiaSearch for more papers by this authorR. Matsumoto, R. Matsumoto Comprehensive Adult Epilepsy Center, Kyoto University Hospital, Kyoto University, Kyoto, JapanSearch for more papers by this authorG. Möddel, G. Möddel Epilepsy Centre, University of Münster, Münster, GermanySearch for more papers by this authorD. Nair, D. Nair Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorS. Noachtar, S. Noachtar Epilepsy Center Munich, University of Munich, Munich, GermanySearch for more papers by this authorC.A. O'Donovan, C.A. O'Donovan Comprehensive Epilepsy Center, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USASearch for more papers by this authorS. Rona, S. Rona Epilepsy Center, University of Freiburg, Freiburg, GermanySearch for more papers by this authorF. Rosenow, F. Rosenow Interdisciplinary Epilepsy Center, University Hospitals, Philipps University, Marburg, GermanySearch for more papers by this authorS. Schuele, S. Schuele Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorC.A. Szabo, C.A. Szabo South Texas Comprehensive Epilepsy Center, University Texas Health Science Center at San Antonio, San Antonio, TX, USASearch for more papers by this authorN. Tandon, N. Tandon Epilepsy Surgery, Dept of Neurosurgery, University of Texas Health Science Center - Houston, Houston, TX, USASearch for more papers by this authorA. Tanner, A. Tanner Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this authorP. Widdess-Walsh, P. Widdess-Walsh Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USASearch for more papers by this author First published: 01 March 2006 https://doi.org/10.1684/j.1950-6945.2006.tb00166.xCitations: 3Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References Acharya JN, Wyllie E, Luders HO, Kotagal P, Lancman M, Coelho M. Seizure symptomatology in infants with localizationrelated epilepsy. 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BACKGROUND:Minute ventilation sensors of cardiac pacemakers measure ventilation by means of transthoracic impedance changes between the pacemaker case and the electrode tip. We investigated whether this technique might detect sleep-related breathing disorders. METHODS AND RESULTS:In 22 patients, analog waveforms of the transthoracic impedance signal measured by the pacemaker minute ventilation sensor over the course of a night were visualized, scored for apnea/hypopnea events, and compared with simultaneous polysomnography. Analysis of transthoracic impedance signals correctly identified the presence or absence of moderate to severe sleep apnea (apnea/hypopnea index, AHI >20 h(-1)) in all patients (receiver operating characteristics, ROC=1.0). The ROC for AHI scores of > or =5 h(-1) and > or =10 h(-1) showed an area under the curve of 0.95, P<0.005, and 0.97, P<0.0001, respectively. Accuracy over time assessed by comparing events per 5-minute epochs was high (Cronbach alpha reliability coefficient, 0.85; intraclass correlation, 0.73). Event-by-event comparison within +/-15 seconds revealed agreement in 81% (kappa, 0.77; P<0.001). CONCLUSIONS:Detection of apnea/hypopnea events by pacemaker minute ventilation sensors is feasible and accurate compared with laboratory polysomnography. This technique might be useful to screen and monitor sleep-related breathing disorders in pacemaker patients.

PURPOSE: Little data are available regarding the prevalence and characteristics of REM-OSA. We describe the prevalence and characteristics of REM-OSA.

PURPOSE:To determine the lateralizing value of ictal urinary urgency. METHODS:A retrospective database search was performed for patients with ictal urinary urgency admitted to the Epilepsy Monitoring Unit at the Cleveland Clinic between 1994 and 2001. RESULTS:Six patients were identified; intracarotid amytal test demonstrated left hemispheric speech dominance in five cases. The sixth patient continued to speak during right temporal seizures. EEG and imaging data supported right temporal or frontotemporal epilepsy in all six cases. Two patients were seizure free after focal right hemispheric resection. CONCLUSIONS:Ictal urinary urge appears to be a lateralizing sign for nondominant temporal lobe epilepsy.