Some Guidelines for Assessment of Spikes and Sharp Waves in EEG Tracings

Maulsby, Robert L.

doi:10.1080/00029238.1971.11080808

Cited by 58 publications

(17 citation statements)

References 4 publications

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“…The previous IFCN definitions of IEDs were conceptual, 20 , 21 lacking specific rules for clinical implementation. Maulsby 22 proposed a set of practical guidelines for assessment of IEDs. Many of them translate to the current criteria: “Every spikey-looking wave is an artifact unless there are one or more good reasons for suspecting otherwise” (similar to criterion 3 in source space); IEDs “occupy a definable electrical field on the scalp” (similar to criterion 6 in sensor space); IEDs “are followed by a slow wave or series of slow deflections” (criterion 4 in sensor space); ignore sharp transients “which can be logically explained by simple alterations in voltage of the existing background rhythm” (criterion 2 in sensor space).…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Normal sharp transients are often misread as IEDs. 2,6,14 There have been several attempts to develop criteria for identifying IEDs, 3,5,7,[15][16][17][18][19][20][21][22] and the International Federation of Clinical Neurophysiology (IFCN) has recently proposed an operational definition of IEDs. 23 However, these criteria have not yet been clinically validated.…”

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confidence: 99%

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Criteria for defining interictal epileptiform discharges in EEG

et al. 2020

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ObjectiveTo define and validate criteria for accurate identification of EEG interictal epileptiform discharges (IEDs) using (1) the 6 sensor space criteria proposed by the International Federation of Clinical Neurophysiology (IFCN) and (2) a novel source space method. Criteria yielding high specificity are needed because EEG over-reading is a common cause of epilepsy misdiagnosis.MethodsSeven raters reviewed EEG sharp transients from 100 patients with and without epilepsy (diagnosed definitively by video-EEG recording of habitual events). Raters reviewed the transients, randomized, and classified them as epileptiform or nonepileptiform in 3 separate rounds: in 2, EEG was reviewed in sensor space (scoring the presence/absence of each IFCN criterion for each transient or classifying unrestricted by criteria [expert scoring]); in the other, review and classification were performed in source space.ResultsCutoff values of 4 and 5 criteria in sensor space and analysis in source space provided high accuracy (91%, 88%, and 90%, respectively), similar to expert scoring (92%). Two methods had specificity exceeding the desired threshold of 95%: using 5 IFCN criteria as cutoff and analysis in source space (both 95.65%); the sensitivity of these methods was 81.48% and 85.19%, respectively.ConclusionsThe presence of 5 IFCN criteria in sensor space and analysis in source space are optimal for clinical implementation. By extracting these objective features, diagnostic accuracy similar to expert scorings is achieved.Classification of evidenceThis study provides Class III evidence that IFCN criteria in sensor space and analysis in source space have high specificity (>95%) and sensitivity (81%–85%) for identification of IEDs.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Criteria for defining interictal epileptiform discharges in EEG

et al. 2020

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“…For interpreting the IEDs we used the guidelines adopted by Maulsby (1971). Physiological sharp waves (vertex transients, K-complexes), EKG artifact, and environmental artifacts, as well as electrode artifacts, were identified and excluded.…”

Section: Methodsmentioning

confidence: 99%

Sharp Slow Waves in the EEG

Janati¹,

ALGhasab

Alshammari

et al. 2016

The Neurodiagnostic Journal

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There exists a paucity of data in the EEG literature on characteristics of "atypical" interictal epileptiform discharges (IEDs), including sharp slow waves (SSWs). This article aims to address the clinical, neurophysiological, and neuropathological significance of SSW The EEGs of 920 patients at a tertiary-care facility were prospectively reviewed over a period of one year. Thirty-six patients had SSWs in their EEG. Of these, 6 patients were excluded because of inadequate clinical data. The clinical and neuroimaging data of the remaining 30 patients were then retrospectively collected and reviewed, and the findings were correlated. The data revealed that SSWs were rare and age-related EEG events occurring primarily in the first two decades of life. All patients with SSWs had documented epilepsy, presenting clinically with partial or generalized epilepsy. It is notable that one-third of the patients with SSWs had chronic or static central nervous system (CNS) pathology, particularly congenital CNS anomalies. Though more than one mechanism may be involved in the pathogenesis of SSWs, this research indicates that the most compelling theory is a deeply seated cortical generator giving rise to this EEG pattern. The presence of SSWs should alert clinicians to the presence of partial or generalized epilepsy or an underlying chronic or static CNS pathology, in particular congenital CNS anomalies, underscoring the significance of brain magnetic resonance imaging in the work-up of this population.

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“…In both awake and anesthetized mice we imaged a 8 Â 8 mm field of view through an intact transparent skull preparation. iGluSnFR demonstrates rapid and robust kinetics during cortical representation of sensory stimulation, that is then paralleled in spontaneous cortical activity with maps recovered up to alpha frequencies (8)(9)(10)(11)(12). iGluSnFR also resolved other features of sensory processing such as an intracortical rebound during the processing visual stimuli that was not seen with other GECIs.…”

Section: Brain-0489mentioning

confidence: 92%

Non–Registered Abstracts

2016

J Cereb Blood Flow Metab

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The problem of a stroke is the focus the medical community that is caused high rates of morbidity, mortality and disability of the survived patients (85%). The purpose of research is studying of risk factors (RF) of stroke. Methods: Prevalence of risk factors and their influence on development of a fatal outcome in 853 patients with a stroke is studied. The outcome of a stroke was estimated for the 28th day from the beginning of a disease. All available sources of information were used: data of interview and examination of the patients, interview to relatives, patient's records, cards of the outpatient, cards of calls of ambulance and the medical death certificates. Results: The rate of stroke in men was 45,5%, women -54,5%. The prevalence of arterial hypertension was 79,4% (women > men). AH of stage I met more often at the survived patients while AH of stage II and III prevailed in group of the dead. The most of patients with AH didn't receive regular hypotensive therapy (72,97%). It was noticed that patients were treated more often sporadically or not treated absolutely in group of the dead. The prevalence of smoking was 30,4% in the studied group (men > women). Prevalence of cardiovascular diseases was 44,2% (women > men). The obliterating atherosclerosis of the lower extremities takes a leading place among vascular diseases, and ischemic heart disease (IHD) -among heart diseases which main form is angina pectoris. IHD is associated more often with a fatal outcome. Prevalence of atrial fibrillation was 16,8% in the studied group (women > men). The myocardial infarction was observed in 13.3% among the examined patients. This indicator was much higher at men, than at women. Diabetes mellitus was revealed at 14,4%, prevalence was much higher at women. When comparing the groups which survived and died it is established that diabetes mellitus is associated with a fatal stroke more often. Frequency of all RF was higher in the group of the died patients. It is established that one RF is observed at 20,98% examined. The most of patients had a combination of two (33,2%), three (25,2%), four (12,7%), five and more (3,9%) RF. Conclusion: AH (79,4%), heart diseases (44,2%) and smoking (30,4%) are the most significant RF of a stroke in the studied population. The prevalence of smoking is 7 times higher, of myocardial infarction is twice higher in group of men. AH, heart diseases meet in group of women more often, prevalence of diabetes mellitus is 3 times higher. AH stage II and III, absence or an irregularity of reception the antihypertensive drugs, existence of angina pectoris, atrial fibrillation, diabetes mellitus were the adverse factors influencing a stroke outcome. Results of the analysis of material give the chance to develop reasonable recommendations about prevention and the organization of medical care by the patient with acute cerebrovascular disease.

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Some Guidelines for Assessment of Spikes and Sharp Waves in EEG Tracings

Cited by 58 publications

References 4 publications

Criteria for defining interictal epileptiform discharges in EEG

Criteria for defining interictal epileptiform discharges in EEG

Sharp Slow Waves in the EEG

Non–Registered Abstracts

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