Changes in interictal pretreatment and posttreatment EEG in childhood absence epilepsy

AbstractSpike and wave discharges (SWDs) are the characteristic manifestation of childhood absence epilepsy (CAE). It has long been believed that they unpredictably emerge from otherwise almost normal interictal EEG. Herein, we demonstrate that pretreatment closed-eyes theta and beta EEG wavelet powers of CAE patients (20 girls and 10 boys, mean age 7.4 ± 1.9 years) are much higher than those of age-matched controls at multiple sites of 10-20 system. For example, at C4 site, we observed a 91% and 62% increase in power of theta and beta rhythms, respectively. We were able to compare the baseline and posttreatment wavelet power in 16 patients. The pharmacotherapy brought about a statistically significant decrease in delta and theta wavelet power in all the channels, e.g. for C4 the reduction was equal to 45% (delta) and 65% (theta). We also observed a less pronounced attenuation of posttreatment beta rhythm in several channels. We hypothesize that the increased theta and beta powers result from cortical hyperexcitability and propensity for epileptic spikes generation, respectively. We argue that the distinct features of CAE wavelet power spectrum may be used to define an EEG biomarker which could be used for diagnosis and monitoring of patients.

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Syndromic classification of patients with typical absence seizures

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2003000400010 ◽

2003 ◽

Vol 61 (3A) ◽

pp. 580-587 ◽

Cited By ~ 7

Author(s):

Laura M.F.F. Guilhoto ◽

Maria Luíza G. Manreza ◽

Elza M.T. Yacubian

Keyword(s):

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy ◽

Interictal Eeg ◽

Syndromic Diagnosis ◽

Juvenile Absence Epilepsy ◽

Ilae Classification ◽

Video Eeg ◽

Spike Wave

The aim of this study is to compare ILAE classification (1989) and Panayiotopoulos' criteria (1997) for absence epilepsies. We studied 455 typical absences (ILAE, 1981) by video-EEG in 43 patients with normal neurological and neuroradiological examinations and interictal EEG with spike-wave complexes higher than 2.5Hz. Syndromic diagnosis was possible in 60.5% and 67.4% of the patients using ILAE classification and Panayiotopoulos' proposal, respectively. According to ILAE criteria 19 patients had childhood absence epilepsy (CAE), five juvenile absence epilepsy (JAE), one juvenile myoclonic epilepsy (JME) and one epilepsy with specific modes of seizure precipitation. According to Panayiotopoulos' proposal, 10 had CAE, 14 JAE, one JME, three myoclonic absence epilepsy and one eyelid myoclonia with absences. We conclude that Panayiotopoulos' criteria and ILAE classification for absence epilepsies, which did not allow for the classification of 32.6% and 39.5% of cases, respectively, were still insufficient to classify all patients under specific diagnosis.

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Ethosuximide, Valproic Acid, and Lamotrigine in Childhood Absence Epilepsy

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2010.12.021 ◽

2011 ◽

Vol 2011 ◽

pp. 35-36

Author(s):

M.J. Brodie

Keyword(s):

Valproic Acid ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy

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Two epileptic syndromes, one brain: Childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2012.05.084 ◽

2012 ◽

Vol 2012 ◽

pp. 11-12

Author(s):

J. Kevill

Keyword(s):

Absence Epilepsy ◽

Childhood Epilepsy ◽

Childhood Absence Epilepsy ◽

Epileptic Syndromes

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Faculty Opinions recommendation of Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.2440956.2076054 ◽

2010 ◽

Author(s):

Gihan Tennekoon ◽

Nicholas Abend ◽

Courtney Wusthoff

Keyword(s):

Valproic Acid ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy

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Co-existence of Rolandic and 3 Hz Spike-Wave Discharges on EEG in Children with Epilepsy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.364 ◽

2018 ◽

Vol 46 (1) ◽

pp. 64-70 ◽

Cited By ~ 3

Author(s):

Anita N. Datta ◽

Laura Wallbank ◽

Peter K. H. Wong

Keyword(s):

Clinical Data ◽

Seizure Control ◽

Age Of Onset ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy ◽

Drug Induced ◽

Favorable Prognosis ◽

Spike Wave Discharges ◽

Spike Wave

AbstractObjectiveBenign epilepsy of childhood with central temporal spikes (BECTS) and absence epilepsy are common epilepsy syndromes in children with similar age of onset and favorable prognosis. However, the co-existence of the electrocardiogram (EEG) findings of rolandic spike and 3 Hz generalized spike-wave (GSW) discharges is extremely rare, with few cases reported in the literature. Our objective was to characterize the EEG findings of these syndromes in children in our center and review the electro-clinical features.MethodsAll EEGs at BC Children’s Hospital are entered in a database, which include EEG findings and clinical data. Patients with both centro-temporal spikes and 3 Hz GSW discharges were identified from the database and clinical data were reviewed.ResultsAmong the 43,061 patients in the database from 1992 to 2017, 1426 with isolated rolandic discharges and 528 patients with isolated 3 Hz GSW discharges were identified, and 20 (0.05%) patients had both findings: 3/20 had BECTS, and subsequently developed childhood absence epilepsy and 17/20 had no seizures characteristic for BECTS. At follow-up, 17 (85%) were seizure-free, 1 (5%) had rare, and 2 (10%) had frequent seizures.ConclusionsThis is the largest reported group of patients to our knowledge with the co-existence of rolandic and 3 Hz GSW discharges on EEGs in one institution, not drug-induced. As the presence of both findings is extremely rare, distinct pathophysiological mechanisms are likely. The majority had excellent seizure control at follow-up, similar to what would be expected for each type of epilepsy alone.

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