Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy

Yeom, Jung Sook; Kim, Youngsoo; Lee, Jun Hwa; Jung, Sung-Jin; Kwon, Oh-Young

doi:10.1016/j.seizure.2015.07.008

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…This concerned both patients with temporal seizures and those with JME. Of note is that symmetrical patterns were not observed in patients with absence seizures, where the discharges are usually bilateral, symmetric, and synchronous [28,29]. Apart from this, we found no significant correlation between particular patterns and the type of epilepsy.…”

Section: Results Discussioncontrasting

confidence: 69%

Patterns of intrahemispheric propagation in pediatric photoparoxysmal response

Skadorwa

Strzelecka

2017

Seizure

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Section: Results Discussioncontrasting

confidence: 69%

Patterns of intrahemispheric propagation in pediatric photoparoxysmal response

Skadorwa

Strzelecka

2017

Seizure

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“…In addition, Yeom et al explored the prognostic significance of the localization of the GSWD generator in CAE patients [ 73 ], following previous functional magnetic resonance imaging studies which highlighted that cortical GSWD generators were associated with a less satisfactory seizure control compared with “classical” thalamic sources [ 74 ]. The researchers used exact low-resolution brain electromagnetic tomography analysis to examine current sources of averaged GSWDs and found a significantly higher involvement of the temporal lobe in drug-resistant CAE patients compared with ASM-responsive ones, in line with previous functional magnetic resonance findings.…”

Section: The Emerging Role Of Advanced Eeg Analysis In the Identifica...mentioning

confidence: 99%

EEG Markers of Treatment Resistance in Idiopathic Generalized Epilepsy: From Standard EEG Findings to Advanced Signal Analysis

et al. 2022

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Idiopathic generalized epilepsy (IGE) represents a common form of epilepsy in both adult and pediatric epilepsy units. Although IGE has been long considered a relatively benign epilepsy syndrome, a remarkable proportion of patients could be refractory to treatment. While some clinical prognostic factors have been largely validated among IGE patients, the impact of routine electroencephalography (EEG) findings in predicting drug resistance is still controversial and a growing number of authors highlighted the potential importance of capturing the sleep state in this setting. In addition, the development of advanced computational techniques to analyze EEG data has opened new opportunities in the identification of reliable and reproducible biomarkers of drug resistance in IGE patients. In this manuscript, we summarize the EEG findings associated with treatment resistance in IGE by reviewing the results of studies considering standard EEGs, 24-h EEG recordings, and resting-state protocols. We discuss the role of 24-h EEG recordings in assessing seizure recurrence in light of the potential prognostic relevance of generalized fast discharges occurring during sleep. In addition, we highlight new and promising biomarkers as identified by advanced EEG analysis, including hypothesis-driven functional connectivity measures of background activity and data-driven quantitative findings revealed by machine learning approaches. Finally, we thoroughly discuss the methodological limitations observed in existing studies and briefly outline future directions to identify reliable and replicable EEG biomarkers in IGE patients.

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“…» The composition of the epileptic network may influence drug responsiveness Szaflarski et al [99] reported that VPA-resistant and VPA-responsive patients may have different spike-wave generators and that these differences in generalized seizures may be the reason for different responses to VPA. Yeom et al [100] found that an initial ASM failure was associated with temporal involvement in the current source distribution of CAE patients. This electrophysiological information, also called "pharmaco-EEG," may be helpful in clinical practice by enabling estimation in advance of the efficacy of initial ASM treatment in ASM-naïve CAE patients.…”

Section: Precision Therapymentioning

confidence: 99%

Generalized absence seizures: Where do we stand today?

Stefan

Trinka

2022

Z. Epileptol.

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Generalized absence seizures are discussed here with respect to changing scientific concepts and newer findings, challenging the strict dichotomy of “generalized” vs. “focal” which may be counterproductive to the development of new ideas and treatments. Data from semiology, structural, and functional studies using quantitative electroencephalography (EEG), video-EEG monitoring, magnetoencephalography, magnetic resonance imaging, and positron emission tomography as well as neuropathology suggest a nosological spectrum from focal to generalized seizure-generating mechanisms. The terms “focal” and “generalized” as used to describe seizures represent abstractions and idealizations rather than ontological entities. The new terminology and classification of the ILAE (2017), despite its enormous merits, unfortunately also facilitates and fosters reductionist thinking, which may be pragmatic from a utilitarian perspective, but risks hindering scientific developments for the future. For instance, the seizure semiology of absences as a paradigmatic generalized seizure type is now classified as “non-motor seizure.” A detailed phenomenological analysis reveals that motor activity is an integral part of this seizure type. Many motor and so-called automatic absence symptoms can be understood as correlated elements of a general organization plan of the cortex. Corresponding functional and structural changes seen in imaging and high-resolution electrophysiology studies indicate focal contributions to seizure generation and a combination of focal and generalized features. Functional findings indicate that the frontal lobe with its projections to other brain areas may play an important role in generalized absence seizures. In this critical review we assess the evolution of pathophysiological concepts through the ages and present new research approaches for diagnosis and treatment.

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Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy

Abstract: Initial AED failure was associated with temporal involvement in the CSD of CAE patients. This electrophysiological information may be helpful in clinical practice by estimating the efficacy of initial AED treatment in AED-naïve CAE patients in advance.

Cited by 6 publications

References 38 publications

Patterns of intrahemispheric propagation in pediatric photoparoxysmal response

Patterns of intrahemispheric propagation in pediatric photoparoxysmal response

EEG Markers of Treatment Resistance in Idiopathic Generalized Epilepsy: From Standard EEG Findings to Advanced Signal Analysis

Generalized absence seizures: Where do we stand today?

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