Interictal EEG pattern in West syndrome

OBJECTIVEThe aim of this study was to evaluate the electro-clinical features, etiology, treatment, and postsurgical seizure outcomes in patients with intractable epileptic spasms (ESs).METHODSThe authors retrospectively studied the medical records of all patients who had presented with medically intractable ESs and had undergone surgery in the period between October 2009 and August 2015. The interictal electroencephalography (EEG) pattern, MRI studies, magnetoencephalography findings, and postsurgical seizure outcomes were compared.RESULTSTwenty-six patients, 12 boys and 14 girls (age range 3–22 years), were eligible for study inclusion. Of these 26 patients, 84.6% (22) presented with multiple seizure types including partial seizures (PSs) independent of the ESs (30.8%); ESs followed by tonic seizures (30.8%); myoclonic seizures (19.2%); tonic seizures (19.2%); ESs followed by PSs (19.2%); focal seizures with secondary generalization (15.4%); atypical absence (11.5%); PSs followed by ESs (7.7%); and myoclonic followed by tonic seizures (7.7%). Seventeen patients underwent multilobar resection and 9 underwent unilobar resection. At the last follow-up (mean 36.6 months), 42.3% of patients were seizure free (outcome classification [OC] 1), 23.1% had > 50% reduction in seizure frequency (OC2–OC4), and 34.6% had < 50% reduction in seizure frequency or no improvement (OC5 and OC6). Predictors of favorable outcomes included an interictal focal EEG pattern and concordance between interictal EEG and MRI-demonstrated lesions (p = 0.001 and 0.004, respectively).CONCLUSIONSA favorable surgical outcome is achievable in a highly select group of patients with ESs secondary to structural lesions. Interictal EEG can help in identifying patients with the potential for favorable resective outcomes.

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Fast oscillation dynamics during hypsarrhythmia as a localization biomarker

Journal of Neurophysiology ◽

10.1152/jn.00662.2017 ◽

2018 ◽

Vol 119 (2) ◽

pp. 679-687 ◽

Cited By ~ 3

Author(s):

Min-Jee Kim ◽

Mi-Sun Yum ◽

Hye-Ryun Yeh ◽

Tae-Sung Ko

Keyword(s):

Brain Lesions ◽

West Syndrome ◽

Fast Oscillation ◽

Pathologic Lesions ◽

The Mean ◽

Oscillation Dynamics ◽

Fast Oscillations ◽

Spectral Perturbation ◽

The Brain ◽

Eeg Pattern

Hypsarrhythmia in West syndrome, although hard to define, is characterized by chaotic and disorganized electrical activity of the brain and is often regarded as a generalized EEG pattern without any localization value. Using event-related spectral perturbation (ERSP), we tried to determine the brain dynamics during hypsarrhythmia. Routine 1-h scalp EEGs were retrieved from 31 patients with infantile spasms and 20 age-matched controls. Using the EEGLAB toolbox of MATLAB 2015b, the ERSPs of fast oscillations (FOs; 20–100 Hz) of selected channels were analyzed and compared among groups according to their MRI lesions. FO-ERSP cutoff values for predicting the pathologic foci were estimated. The mean FO-ERSPs across all analyzed electrodes of patients with spasms were significantly higher than those of controls. When the patients were categorized into nonlesional, focal/multifocal, or diffuse lesional groups, the FO-ERSP of patients in the focal/multifocal lesional group was significantly lower than that of those in the nonfocal or diffuse lesional groups. In the focal/multifocal lesional group, seven patients (7/9, 77.8%) showed that the locations of channels with high FO-ERSPs were matched to the pathologic MRI lesions. Thus, the localization of high FO-ERSPs is closely associated with the location of pathologic brain lesions. Further research is required to prove the value of the FO-ERSP as an important quantitative localizing biomarker of West syndrome. NEW & NOTEWORTHY The locations of high fast oscillation-event-related spectral perturbations (FO-ERSPs) are closely associated with brain pathologic lesions, and high FO-ERSPs can be used as a localization biomarker of pathologic brain lesions in patients with hypsarrhythmia. With further validation, FO-ERSP might be useful as a biomarker for the localization of hidden pathologies in conditions with generalized epileptiform activities such as West syndrome.

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Interictal EEG pattern in rabbit penicillin epilepsy

The Italian Journal of Neurological Sciences ◽

10.1007/bf02283019 ◽

1986 ◽

Vol 7 (4) ◽

pp. 413-420

Author(s):

G. Gallitto ◽

R. Musolino ◽

M. Bonanzinga ◽

P. De Domenico ◽

G. Distefano ◽

...

Keyword(s):

Interictal Eeg ◽

Eeg Pattern

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Prognostic value of EEG in West syndrome

Vojnosanitetski pregled ◽

10.2298/vsp160214384n ◽

2018 ◽

Vol 75 (9) ◽

pp. 935-939

Author(s):

Dimitrije Nikolic ◽

Ivan Milovanovich ◽

Biljana Medjo ◽

Marina Atanaskovic ◽

Petar Ivanovski ◽

...

Keyword(s):

Prognostic Value ◽

Seizure Control ◽

Disease Onset ◽

Epileptic Encephalopathy ◽

West Syndrome ◽

Seizure Type ◽

Psychomotor Delay ◽

One Year ◽

Eeg Pattern

Background/Aim. West syndrome (WS) is an epileptic encephalopathy which is characterized by the trias: infantile spasms, psychomotor delay and specific electroencephalography (EEG) pattern. The aim of this study was to determine the prognostic value of EEG in the therapy of West syndrome. Methods. This study group comprised 68 patients (40 boys and 28 girls) with the diagnosis of WS. Criteria for inclusion of patients in this study were the disease onset in the first or the second year of life, specific seizure type and a characteristic EEG pattern. All patients were divided into 2 groups: symptomatic (37 patients) and cryptogenic (31 patients) WS. The outcome was assessed through the response to the therapy (seizure control and EEG findings). Follow-up was at 3, 6, 12 and 24 months after the diagnosis was established. Results. Three months after starting the treatment 80.6% of patients with improved EEG were seizure free (p < 0.01); 85.7% of patients with EEG improvement at 3 months check-up were seizure free after 6 months (p < 0.01); 82.8% of patients with better EEG findings after 3 months had no seizures after 12 months (p < 0.05). Also, the majority of patients with improvement in EEG at 6 month follow-up (95.8%) had no seizures at one year follow-up (p < 0.01). The presence of seizures during this period did not depend on EEG after 6 months of treatment (p > 0.05). Most of the patients with improved (89.7%) and unchanged (70.6%) EEG after 12 months had no seizures after two years, whereas the patients with worsened EEG were with seizures. Conclusion. Seizure control after 6, 12 and 24 months depended on EEG finding at 3 months follow up. Seizure control after 12 months correlated with EEG after 6 months. The correlation between EEG after 12 months and seizure control after 24 months was not clear. EEG at 6 months follow-up did not affect seizure control after 2 years.

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