EEG criteria predictive of complicated evolution in idiopathic rolandic epilepsy

Massa, Rita; Saint‐Martin, Anne de; Carcangiu, Roberta; Rudolf, Gabrielle; Seegmüller, Caroline; Kleitz, Catherine; Metz‐Lutz, Marie‐Noëlle; Hirsch, Édouard; Marescaux, Christian

doi:10.1212/wnl.57.6.1071

Cited by 253 publications

(276 citation statements)

References 34 publications

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“…In contrast to CZP, no EEG normalization could be found in the 10 patients treated with CBZ in that study. In addition, CBZ may have the disadvantage of worsening EEG characteristics and precipitating of epilepsy with continuous spikes and waves during slow sleep (CSWS) in a considerable number of patients (3,4,(9)(10)(11)(12)(13), although this influence is controversial (14). Early observations showed positive effects of STM treatment on the interictal EEG in BECTS (2,11,15).…”

Section: Discussionmentioning

confidence: 99%

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The Influence of Sulthiame on EEG in Children with Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS)

Bast

Völp²,

Wolf

et al. 2003

Epilepsia

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Summary:Purpose: To evaluate the effects of sulthiame (Ospolot; STM) monotherapy compared with placebo on the EEG in children with benign childhood epilepsy with centrotemporal spikes (BECTS).Methods: Sixty-six patients (aged 3-11 years) entered a 6-month double-blind trial and were randomized to either STM (n ‫ס‬ 31) or placebo (n ‫ס‬ 35). Clinical data and general results have been reported elsewhere (1). One-hundred seventy-nine sleep EEGs were recorded at screening and after 4 weeks, 3 months, and 6 months. EEGs were analyzed by a blind reviewer using a standard protocol for each EEG. This standard protocol collected data on general changes, specific epileptiform, and nonspecific focal and generalized changes. A classification system was defined depending on rating of pathologic EEG changes. Because of the higher number of treatment-failure events (i.e., seizures) in the placebo group, there was an increasing imbalance between the two groups regarding the number of recorded sleep EEGs over time (STM, 104; placebo, 74). A Wilcoxon-Mann-Whitney U test was used to describe differences in the grade of pathology during individual follow-up between the two groups.Results: The sleep-EEG was found to be normalized in 21 patients treated with STM (12/21 transient) and in five patients treated with placebo (4/5 transient). In the STM group, the EEG showed a marked improvement during intraindividual course when comparing the classification of follow-up EEGs at each time point with the screening EEG. Comparable improvements were not observed in the placebo group (exact two-tailed p value at 4 weeks, p < 0.0001; at 3 months, p ‫ס‬ 0.0010; and at 6 months, p < 0.0001).Conclusions: STM had marked effects on the EEG in BECTS, which led to normalization in the majority of the patients. Most of those whose EEGs were not normalized showed improvement in the grade of EEG pathology. Normalization persisted in >50% of patients during the investigation. Spontaneous normalization in the placebo group reflects the wide spectrum of individual courses, which must be considered when analyzing drug effects on EEG in BECTS.

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Section: Discussionmentioning

confidence: 99%

“…Some reports point to the role of interictal EEG changes for developing neuropsychological deficiencies in BECTS (3,4). As the disease is associated with a wide variability of intraindividual EEG courses, including spontaneous normalization (5), a blinded, placebo-controlled investigation is necessary for analyzing drug effects on the EEG in BECTS.…”

mentioning

confidence: 99%

The Influence of Sulthiame on EEG in Children with Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS)

Bast

Völp²,

Wolf

et al. 2003

Epilepsia

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“…The frequency of different group of EEG wave patterns are as shown in fig III. The relationship of various types of seizures with EEG-patterns showed that concordance and discordance EEG findings such as clinically diagnosed primarily generalized seizure n= 327, 145(discordance rate of 44.34%) had normal EEG, and 182 (concordance 55.66%), partial seizures with secondary generalization n=284, abnormal EEG were found in 73 (concordance 25.7%) normal EEG in 211,(discordance74.3%), partial seizure n= 46, abnormal EEG was in 29( concordance of 63.04%) and normal in 17 ( discordance of 36.96%) and complex partial seizure n=72 normal EEG in 31 (discordance of 43.06%)and abnormal EEG of 41(concordance of 56.94%). 14 found the EEG-abnormalities were epileptiform activity, in 54%of the cases. AlSuleiman (2001) 15 , found the EEG-abnormalities were epileptiform activity, in 51%of the cases.…”

Section: Resultsmentioning

confidence: 90%

Seizure type and interictal epileptiform EEG patterns in Nigerians

Osalusi¹

2017

JMSCR

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“…Earlier studies disclosed that the disruptive effect of a single IED is directly proportional to the voltage of the wave but not the spike (Shewmon and Erwin, 1988c). This observation and the direct relationship between the spatio-temporal amount of the spikewave series and the severity of the deficit symptoms in the long run (Metz-Lutz et al, 1999;Baglietto et al, 2001;Massa et al, 2001) are independently derived findings but lead to the same conclusion: the greater the degree of neuronal synchronization over time and space the greater the cortical dysfunction. As to avoid confusion in this paper "synchronization" refers to the synchronous activation of great cortical neuronal masses (Nunez, 1995), the result of which is reflected by the increase of the voltage of the EEG signal (Pfurtscheller and Lopes da Silva, 1999).…”

Section: The Importance and The Assessment Of "Synchronization"mentioning

confidence: 86%

“…However, other investigators described fluctuating neurological symptoms, disturbed speech and cognitive impairment that were related to the presence of frequent IEDs but not strictly time-locked to them. Drug treatment that abolished the spikes caused significant clinical improvement within a short time period (Hirsch et al, 1990;Metz-Lutz et al, 1999;Baglietto et al, 2001;Massa et al, 2001;Dalla Bernardina et al, 2002). Thus, a "delayed effect" of the IEDs might be deductively postulated as an explanation for the lack of the precise temporal coincidence between the IEDs and the time course of the above mentioned symptoms.…”

Section: Introductionmentioning

confidence: 99%

The electrophysiological “delayed effect” of focal interictal epileptiform discharges. A low resolution electromagnetic tomography (LORETA) study

et al. 2009

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Collating the findings regarding the role of focal interictal epileptiform discharges (IEDs) on CNS functions raises the possibility that IEDs might have negative impact that outlasts the duration of the spike-and wave complexes. The aim of this study was the electrophysiological demonstration of the "delayed effect" of the IEDs. 19-channel, linked-ears referenced, digital waking EEG records of eleven children (aged 6-14 years, eight with idiopathic, three with cryptogenic focal epilepsy, showing a single spike focus) were retrospectively selected from our database. A minimum of twenty (preferably, thirty), 2-second epochs containing a single focal spike-and-wave complex were selected (Spike epochs). Thereafter, Postspike-1 (Ps1), Postspike-2 (Ps2) and Postspike-3 (Ps3) epochs were selected, representing the first and second seconds (Ps1), the third and fourth seconds (Ps2) and the fifth and sixth seconds (Ps3) after the Spike epoch, respectively. Interspike epochs (Is) were selected at a distance at least ten seconds after the Spike epoch. Individual analysis: the frequency of interest (FOI = the individual frequency of the wave component of the IEDs), and the region of interest (ROI = the site of the IEDs) were identified by reading the raw EEG waveform and the instant power spectrum.Very narrow-band LORETA (low resolution electromagnetic tomography) analysis at the FOI and ROI was carried out. Age-adjusted, Z-transformed LORETA "activity" (= current source density, ampers / meters squared) was compared in the Spike, Ps1, Ps2, Ps3 and Is epochs. Findings: the greatest (uppermost pathological) Z-scores and the greatest spatial extension of the LORETA-abnormality were always found in the Spike epochs, followed by the gradual decrease of activity in terms of severity and spatial extension in the Ps1, Ps2, Ps3 epochs. The lowest (baseline) level and extension of the abnormality was found in the Is epochs. Group analysis: average values of activity across the patients were computed for the temporal decrease of the abnormality. Findings: a clear tendency for the decrease of abnormality was demonstrated. Conclusion: the "delayed effect" of the IEDs was demonstrated electrophysiologically and quantified. The method may be utilized in the individual assessment of the effect of IEDs on cortical activity, the degree and temporo-spatial extension of the abnormality.

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EEG criteria predictive of complicated evolution in idiopathic rolandic epilepsy

Abstract: Different combinations of at least three of six distinctive interictal EEG patterns and their long-lasting (> or =6-month) persistence seem to be the hallmarks of patients with BECTS at risk for neuropsychological impairments.

Cited by 253 publications

References 34 publications

The Influence of Sulthiame on EEG in Children with Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS)

The Influence of Sulthiame on EEG in Children with Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS)

Seizure type and interictal epileptiform EEG patterns in Nigerians

The electrophysiological “delayed effect” of focal interictal epileptiform discharges. A low resolution electromagnetic tomography (LORETA) study

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