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Zijlmans M, van der Salm SMA, Van't Klooster M. Nasopharyngeal electrodes for recording mesiotemporal spikes: Post-covid revival? Clin Neurophysiol 2021; 132:1718-1720. [PMID: 33985899 PMCID: PMC8080533 DOI: 10.1016/j.clinph.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Maeike Zijlmans
- Stichting Epilepsie Instellingen Nederland (SEIN), the Netherlands; University Medical Center Utrecht, the Netherlands.
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Abstract
SUMMARY Recording of interictal epileptiform discharges to classify the epilepsy syndrome is one of the most common indications for ambulatory EEG. Ambulatory EEG has superior sampling compared with standard EEG recordings and advantages in terms of cost-effectiveness and convenience compared with a prolonged inpatient EEG study. Ambulatory EEG allows for EEG recording in all sleep stages and transitional states, which can be very helpful in capturing interictal epileptiform discharges. In the absence of interictal epileptiform discharges or in patients with atypical events, the characterization of an epilepsy syndrome may require recording of the habitual events. Diagnostic ambulatory EEG can be a useful alternative to inpatient video-EEG monitoring in a selected number of patients with frequent events who do not require medication taper or seizure testing for surgical localization.
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Hwan Yim S, Ho Cho K, Ho Choi Y, Ihn Kim H, Cho YJ, Heo K. Nasopharyngeal electrodes in temporal lobe epilepsy: A reappraisal of their diagnostic utility. Clin Neurophysiol 2021; 132:1741-1751. [PMID: 33896694 DOI: 10.1016/j.clinph.2021.02.395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/02/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare electroencephalography (EEG) recordings with nasopharyngeal electrodes (NPEs) plus anterior temporal electrodes (ATEs) (NPE recordings) and those with only ATEs (non-NPE recordings) for the detection of interictal epileptiform discharges (IEDs) in patients with suspected temporal lobe epilepsy (TLE). METHODS We retrospectively analyzed the initial EEGs of 229 patients that were recorded simultaneously with ATEs and NPEs in addition to the electrodes of the 10-20 system of electrode placement. Two data sets of NPE and non-NPE recordings were reviewed independently by three interpreters with differing degrees of experience. Discordant findings in the interpretation among the three interpreters were resolved by a consensus to yield final results. RESULTS IEDs were detected in 76.4% of patients with NPE recordings compared to 55.5% with non-NPE recordings (p < 0.01). Bilateral independent IEDs were found in 26.2% and 11.4% of EEGs with NPE and non-NPE recordings (p < 0.01). The degree of agreement for the detection of IEDs among the three interpreters was higher with the NPE than with non-NPE recordings (κappa score, 0.70 vs. 0.54). The increased diagnostic yield of NPE recordings for the detection of IEDs was particularly prominent in patients with mesial and non-lesional TLEs. CONCLUSIONS EEG recordings using NPEs are useful to improve the sensitivity and level of agreement among interpreters for the detection of IEDs in patients with TLE. SIGNIFICANCE NPE recordings may be recommended in routine EEGs for the evaluation of patients with suspected TLE.
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Affiliation(s)
- Soo Hwan Yim
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyoo Ho Cho
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yun Ho Choi
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Ihn Kim
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yang-Je Cho
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Heo
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Galaris E, Gallos I, Myatchin I, Lagae L, Siettos C. Electroencephalography source localization analysis in epileptic children during a visual working-memory task. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3404. [PMID: 33029905 DOI: 10.1002/cnm.3404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/15/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
We localize the sources of brain activity of children with epilepsy based on electroencephalograph (EEG) recordings acquired during a visual discrimination working memory task. For the numerical solution of the inverse problem, with the aid of age-specific MRI scans processed from a publicly available database, we use and compare three regularization numerical methods, namely the standardized low resolution brain electromagnetic tomography (sLORETA), the weighted minimum norm estimation (wMNE) and the dynamic statistical parametric mapping (dSPM). We show that all three methods provide the same spatio-temporal patterns of differences between the groups of epileptic and control children. In particular, our analysis reveals statistically significant differences between the two groups in regions of the parietal cortex indicating that these may serve as "biomarkers" for diagnostic purposes and ultimately localized treatment.
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Affiliation(s)
- Evangelos Galaris
- Dipartimento di Matematica e Applicazioni "Renato Caccioppoli", Universita' degli Studi di Napoli Federico II, Napoli, Italy
| | - Ioannis Gallos
- School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Ivan Myatchin
- Department of Anesthesiology, Sint-Trudo Regional Hospital, Sint-Truiden, Belgium
| | - Lieven Lagae
- Department of Development and Regeneration, Section Paediatric Neurology, KU Leuven, Leuven, Belgium
| | - Constantinos Siettos
- Dipartimento di Matematica e Applicazioni "Renato Caccioppoli", Universita' degli Studi di Napoli Federico II, Napoli, Italy
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Tatum W, Rubboli G, Kaplan P, Mirsatari S, Radhakrishnan K, Gloss D, Caboclo L, Drislane F, Koutroumanidis M, Schomer D, Kasteleijn-Nolst Trenite D, Cook M, Beniczky S. Clinical utility of EEG in diagnosing and monitoring epilepsy in adults. Clin Neurophysiol 2018; 129:1056-1082. [DOI: 10.1016/j.clinph.2018.01.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 12/20/2022]
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Skoch J, Adelson PD, Bhatia S, Greiner HM, Rydenhag B, Scavarda D, Mangano FT. Subdural grid and depth electrode monitoring in pediatric patients. Epilepsia 2017; 58 Suppl 1:56-65. [DOI: 10.1111/epi.13685] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Jesse Skoch
- Division of Pediatric Neurosurgery; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio U.S.A
| | - P. David Adelson
- Barrow Neurological Institute at Phoenix Children's Hospital; Phoenix Arizona U.S.A
| | | | - Hansel M. Greiner
- Division of Pediatric Neurosurgery; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio U.S.A
| | - Bertil Rydenhag
- Epilepsy Research Group; Institute of Neuroscience and Physiology; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Didier Scavarda
- Department of Pediatric Neurosurgery; La Timone Children's Hospital; Marseille France
| | - Francesco T. Mangano
- Division of Pediatric Neurosurgery; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio U.S.A
- Barrow Neurological Institute at Phoenix Children's Hospital; Phoenix Arizona U.S.A
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Abstract
INTRODUCTION This study aimed at evaluating the value added by 24-hour ambulatory EEG (AEEG) by comparing the presence of epileptiform discharges (EDs) between the first 30 minutes of recording versus the following 23.5 hours. MATERIALS AND METHODS A retrospective review of AEEGs of subjects divided into two groups, epilepsy and undiagnosed episodes of loss of consciousness, was conducted. AEEGs were divided into early EEG (E-EEG) (first 30 minutes) and extended EEG (remaining 23.5 hours). Extended EEGs were further divided into segments (S): 31st minute to 8th hour (SI), 9th to 16th hours (SII) and 17th to 24th hours (SIII). Each consecutive segment was reviewed to identify new EDs not seen previously. RESULTS Fifty-seven AEEGs were included, the median age being 36.3 years, the range being 18.7 to 78.6 years. There were 38 (66.6%) females. The collective yield of AEEG for detecting EDs was 19/57 (33.4%). The yield of E-EEG of new EDs was 5/57 (9%). During extended EEG, the distribution of EDs was as follows: SI, 12/55 (21.8%); SII, 2/43 (4.6%); and SIII 0/41 (0%). The yield, however, did not increase beyond the 13th hour. In undiagnosed episodes of loss of consciousness group (11), yield was 0/11 in all segments. CONCLUSIONS (1) There was no value added for yield of EDs by extending the EEG recording beyond 13 hours in epilepsy group. (2) The probability of capturing EDs is negligible if the clinical history does not clearly support the diagnosis of seizure or epilepsy.
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Affiliation(s)
- Maria Siddiqi
- a Division of Neurology, Department of Medicine , University of Alberta , Edmonton , Canada
| | - S Nizam Ahmed
- b Clinical Neurophysiology Laboratory, Division of Neurology, Department of Medicine , University of Alberta , Edmonton , Canada
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Protopapa F, Siettos CI, Myatchin I, Lagae L. Children with well controlled epilepsy possess different spatio-temporal patterns of causal network connectivity during a visual working memory task. Cogn Neurodyn 2016; 10:99-111. [PMID: 27066148 PMCID: PMC4805687 DOI: 10.1007/s11571-015-9373-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/30/2015] [Accepted: 12/24/2015] [Indexed: 12/14/2022] Open
Abstract
Using spectral Granger causality (GC) we identified distinct spatio-temporal causal connectivity (CC) patterns in groups of control and epileptic children during the execution of a one-back matching visual discrimination working memory task. Differences between control and epileptic groups were determined for both GO and NOGO conditions. The analysis was performed on a set of 19-channel EEG cortical activity signals. We show that for the GO task, the highest brain activity in terms of the density of the CC networks is observed in α band for the control group while for the epileptic group the CC network seems disrupted as reflected by the small number of connections. For the NOGO task, the denser CC network was observed in θ band for the control group while widespread differences between the control and the epileptic group were located bilaterally at the left temporal-midline and parietal areas. In order to test the discriminative power of our analysis, we performed a pattern analysis approach based on fuzzy classification techniques. The performance of the classification scheme was evaluated using permutation tests. The analysis demonstrated that, on average, 87.6 % of the subjects were correctly classified in control and epileptic. Thus, our findings may provide a helpful insight on the mechanisms pertaining to the cognitive response of children with well controlled epilepsy and could potentially serve as "functional" biomarkers for early diagnosis.
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Affiliation(s)
- Foteini Protopapa
- />School of Applied Mathematics and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Constantinos I. Siettos
- />School of Applied Mathematics and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Ivan Myatchin
- />Department of Woman and Child, Section Paediatric Neurology, K.U. Leuven, Louvain, Belgium
| | - Lieven Lagae
- />Department of Woman and Child, Section Paediatric Neurology, K.U. Leuven, Louvain, Belgium
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Affiliation(s)
- Piyush Ostwal
- Department of Neurology, Padmashree Dr. D Y Patil Medical College, Hospital and Research Centre, Pimpri-Chinchwad, Pune, Maharashtra, India
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Black V, Garosi L, Lowrie M, Harvey RJ, Gale J. Phenotypic characterisation of canine epileptoid cramping syndrome in the Border terrier. J Small Anim Pract 2013; 55:102-7. [PMID: 24372194 PMCID: PMC4277704 DOI: 10.1111/jsap.12170] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To characterise the phenotype of Border terriers suspected to be affected by canine epileptoid cramping syndrome and to identify possible contributing factors. METHODS Owners of Border terriers with suspected canine epileptoid cramping syndrome were invited to complete an online questionnaire. The results of these responses were collated and analysed. RESULTS Twenty-nine Border terriers were included. Most affected dogs had their first episode before 3 years of age (range: 0·2 to 7·0 years). The majority of episodes lasted between 2 and 30 minutes (range: 0·5 to 150 minutes). The most frequent observations during the episodes were difficulty in walking (27 of 29), mild tremor (21 of 29) and dystonia (22 of 29). Episodes most frequently affected all four limbs (25 of 29) and the head and neck (21 of 29). Borborygmi were reported during episodes in 11 of 29 dogs. Episodes of vomiting and diarrhoea occurred in 14 of 29, with 50% of these being immediately before or after episodes of canine epileptoid cramping syndrome (7 of 14). Most owners (26 of 29) had changed their dog's diet, with approximately 50% (14 of 26) reporting a subsequent reduction in the frequency of episodes. CLINICAL SIGNIFICANCE This study demonstrates similarities in the phenotype of canine epileptoid cramping syndrome to paroxysmal dystonic choreoathetosis, a paroxysmal dyskinesia reported in humans. This disorder appears to be associated with gastrointestinal signs in some dogs and appears at least partially responsive to dietary adjustments.
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Affiliation(s)
- V Black
- Davies Veterinary Specialists, Higham Gobion
| | - L Garosi
- Davies Veterinary Specialists, Higham Gobion
| | - M Lowrie
- Davies Veterinary Specialists, Higham Gobion
| | - R J Harvey
- Department of Pharmacology, UCL School of Pharmacy, London
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van Diessen E, Otte WM, Braun KPJ, Stam CJ, Jansen FE. Improved diagnosis in children with partial epilepsy using a multivariable prediction model based on EEG network characteristics. PLoS One 2013; 8:e59764. [PMID: 23565166 PMCID: PMC3614973 DOI: 10.1371/journal.pone.0059764] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/18/2013] [Indexed: 11/20/2022] Open
Abstract
Background Electroencephalogram (EEG) acquisition is routinely performed to support an epileptic origin of paroxysmal events in patients referred with a possible diagnosis of epilepsy. However, in children with partial epilepsies the interictal EEGs are often normal. We aimed to develop a multivariable diagnostic prediction model based on electroencephalogram functional network characteristics. Methodology/Principal Findings Routinely performed interictal EEG recordings at first presentation of 35 children diagnosed with partial epilepsies, and of 35 children in whom the diagnosis epilepsy was excluded (control group), were used to develop the prediction model. Children with partial epilepsy were individually matched on age and gender with children from the control group. Periods of resting-state EEG, free of abnormal slowing or epileptiform activity, were selected to construct functional networks of correlated activity. We calculated multiple network characteristics previously used in functional network epilepsy studies and used these measures to build a robust, decision tree based, prediction model. Based on epileptiform EEG activity only, EEG results supported the diagnosis of with a sensitivity and specificity of 0.77 and 0.91 respectively. In contrast, the prediction model had a sensitivity of 0.96 [95% confidence interval: 0.78–1.00] and specificity of 0.95 [95% confidence interval: 0.76–1.00] in correctly differentiating patients from controls. The overall discriminative power, quantified as the area under the receiver operating characteristic curve, was 0.89, defined as an excellent model performance. The need of a multivariable network analysis to improve diagnostic accuracy was emphasized by the lack of discriminatory power using single network characteristics or EEG's power spectral density. Conclusions/Significance Diagnostic accuracy in children with partial epilepsy is substantially improved with a model combining functional network characteristics derived from multi-channel electroencephalogram recordings. Early and accurate diagnosis is important to start necessary treatment as soon as possible and inform patients and parents on possible risks and psychosocial aspects in relation to the diagnosis.
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Affiliation(s)
- Eric van Diessen
- Rudolf Magnus Institute of Neuroscience, Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
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Chowdhury RN, Hasan AH, Rahman KM, Mondol BA, Deb SR, Mohammad QD. Interictal EEG changes in patients with seizure disorder: experience in Bangladesh. SPRINGERPLUS 2013; 2:27. [PMID: 23482637 PMCID: PMC3589623 DOI: 10.1186/2193-1801-2-27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 01/23/2013] [Indexed: 11/29/2022]
Abstract
The objective of this study was to determine the changes and sensitivity of electro encephalogram during interictal period and to evaluate the finding in the clinically suspected seizure events in a tertiary care hospital of Bangladesh. This cross sectional study was carried out in the Electrophysiology Laboratory of Dhaka Medical College Hospital from July 2010 to July 2011, which included 767 patients. EEG was obtained through scalp electrodes following international 10/20 system. Patient and their attendants were interviewed using a semi structured questionnaire. The EEG findings and clinical seizure events were then compared. Among the 767 epilepsy patients most were children (39.9% less than 10 years old) and young adult (33.2% in 11–20 years age group). Female patients predominantly had seizure than male (57% and 43% respectively). The overall sensitivity of EEG in yielding abnormal interictal epileptiform discharges was 62.7%. About 48.5% of them were diagnosed as localization related epilepsy and 11.7% were generalized epilepsy. Morphology showed spike and wave in 74% and sharp and wave in 11% tracings. Only 2% had slow waves. The presence of an interictal spike/sharp wave helps to confirm a clinical diagnosis of epilepsy, aids in defining the epilepsy syndrome, provides information that assists in planning drug management.
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Javidan M. Electroencephalography in mesial temporal lobe epilepsy: a review. EPILEPSY RESEARCH AND TREATMENT 2012; 2012:637430. [PMID: 22957235 PMCID: PMC3420622 DOI: 10.1155/2012/637430] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/17/2012] [Accepted: 02/23/2012] [Indexed: 11/17/2022]
Abstract
Electroencephalography (EEG) has an important role in the diagnosis and classification of epilepsy. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. In temporal lobe epilepsy (TLE) seizures could originate in the medial or lateral neocortical temporal region, and many of these patients are refractory to medical treatment. However, majority of patients have had excellent results after surgery and this often relies on the EEG and magnetic resonance imaging (MRI) data in presurgical evaluation. If the scalp EEG data is insufficient or discordant, invasive EEG recording with placement of intracranial electrodes could identify the seizure focus prior to surgery. This paper highlights the general information regarding the use of EEG in epilepsy, EEG patterns resembling epileptiform discharges, and the interictal, ictal and postictal findings in mesial temporal lobe epilepsy using scalp and intracranial recordings prior to surgery. The utility of the automated seizure detection and computerized mathematical models for increasing yield of non-invasive localization is discussed. This paper also describes the sensitivity, specificity, and predictive value of EEG for seizure recurrence after withdrawal of medications following seizure freedom with medical and surgical therapy.
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Affiliation(s)
- Manouchehr Javidan
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada V5Z 1M9
- Neurophysiology Laboratory, Vancouver General Hospital, Vancouver, BC, Canada V5Z1M9
- Epilepsy Program, Vancouver General Hospital, Vancouver, BC, Canada V5Z 1M9
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The role of the interictal EEG in selecting candidates for resective epilepsy surgery. Epilepsy Behav 2011; 20:167-71. [PMID: 20889385 DOI: 10.1016/j.yebeh.2010.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 08/23/2010] [Indexed: 11/21/2022]
Abstract
The interictal EEG is a noninvasive and useful test for selecting candidates for resective epilepsy surgery, although it has many pitfalls. It is an essential test for the most common drug-resistant epilepsy, mesial temporal sclerosis, and predicts good outcome when interictal epileptiform discharges are concordant with unilateral hippocampal atrophy or sclerosis, and predicts poor outcome when interictal epileptic discharges are discordant with the lesion. Its role in other types of epilepsy surgery, including nonlesional cases and corpus callosotomy, is less clear. Future research gathering large multicenter prospective data is needed to maximize the role of this classic neurophysiological test in the evaluation of candidates for epilepsy surgery.
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Dericioglu N, Colpak AI, Ciger A, Saygi S. The yield of preoperative sequential routine scalp EEGs in patients who underwent anterior temporal lobectomy for mesial temporal sclerosis. Clin EEG Neurosci 2010; 41:166-9. [PMID: 20722353 DOI: 10.1177/155005941004100312] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mesial temporal lobe epilepsy syndrome (MTLES) is the most common surgically remediable epileptic syndrome in adults. Its diagnosis is easy when clinical history is supported by positive laboratory findings. However, routine EEG may not be informative in some patients, thus delaying accurate diagnosis. Therefore, we sought to determine how often routine EEGs displayed epileptiform discharges pre-operatively in a group of patients who underwent surgery for MTLES. Retrospectively, we reviewed the outpatient EEG records of MTLES patients who underwent surgery at our epilepsy center between 1997-2008 and had at least one routine pre-operative EEG recording in our outpatient laboratory. For each patient, serial EEGs were coded as normal, displaying nonspecific abnormalities or lateralized and localized interictal epileptiform discharges. Seventy patients were included in the study. We reviewed 230 EEGs. In almost half of the patients (47.1%) all EEGs were normal or revealed nonspecific findings. In patients who had >1 EEG, almost 3 EEGs had to be recorded to detect the epileptiform discharges for the first time and 6.23 years were needed to accomplish this. Sleep deprivation considerably increased the yield. In summary, patients who have a clinical history suggesting MTLES may need at least 3 routine scalp EEG recordings (with at least one of them after sleep deprivation) to detect epileptiform abnormalities and it may take much time. Therefore, a single prolonged outpatient video-EEG monitoring or an overnight inpatient monitoring might be reasonable alternatives to serial EEGs.
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Affiliation(s)
- Nese Dericioglu
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey.
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Evaluation of Postoperative Sharp Waveforms Through EEG and Magnetoencephalography. J Clin Neurophysiol 2010; 27:7-11. [DOI: 10.1097/wnp.0b013e3181c9b283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kim MJ, Nam SO. Change of interictal epileptiform discharges after antiepiletic drug treatment in childhood epilepsy. KOREAN JOURNAL OF PEDIATRICS 2010. [DOI: 10.3345/kjp.2010.53.4.560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Mun Ju Kim
- Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Gyeongnam, Korea
| | - Sang Ook Nam
- Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Gyeongnam, Korea
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Petramfar P, Yaghoobi E, Nemati R, Asadi-Pooya AA. Serum creatine phosphokinase is helpful in distinguishing generalized tonic-clonic seizures from psychogenic nonepileptic seizures and vasovagal syncope. Epilepsy Behav 2009; 15:330-2. [PMID: 19383552 DOI: 10.1016/j.yebeh.2009.04.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 04/11/2009] [Accepted: 04/14/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Distinguishing epileptic generalized tonic-clonic seizures (GTCS) from either psychogenic nonepileptic seizures (PNES) or vasovagal syncope (VVS) is important. In this study, we investigated the use of postictal serum creatine phosphokinase (CPK) concentrations in distinguishing between these events. METHODS Patients admitted to the Neurology Ward at Namazi Hospital in Shiraz, Iran, with an attack of transient loss of consciousness and abnormal movements witnessed by a neurologist were studied. We categorized the patients into three groups: 20 patients with GTCS, 22 with VVS, and 20 with PNES. A group of 20 normal healthy individuals were included in the study as the control group. Serum CPK concentration was measured 12-15 h after the attack in all patients and at one time in the control group. A P value less than 5% was considered significant. RESULTS There were no significant differences between the four groups with respect to age and sex. Mean CPK concentrations statistically significantly differed between the four groups, with higher levels in patients with GTCS (P=0.0001). Serum CPK concentration had a sensitivity of 75% and specificity of 86% for the diagnosis of GTCS. CPK concentration was above 160 mg/dl in 75% of patients with GTCS, 15% of patients with PNES, 13.6% of patients with VVS, and 15% of the control group (P=0.0001). The PNES, VVS, and control groups did not statistically significantly differ with respect to CPK concentrations. CONCLUSION In patients with a recent loss of consciousness and abnormal movements, serum CPK concentration is a useful, practical, and relatively accurate parameter to assist in the differentiation of epileptic seizures from either VVS or PNES.
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Affiliation(s)
- Peyman Petramfar
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Zijlmans M, Huiskamp GM, van Huffelen AC, Spetgens WP, Leijten FS. Detection of temporal lobe spikes: Comparing nasopharyngeal, cheek and anterior temporal electrodes to simultaneous subdural recordings. Clin Neurophysiol 2008; 119:1771-1777. [DOI: 10.1016/j.clinph.2008.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2007] [Revised: 04/09/2008] [Accepted: 04/10/2008] [Indexed: 10/22/2022]
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Abstract
The interictal EEG provides information that aids in diagnosis and management of epilepsy. One must remember that the EEG is merely a tool, and its usefulness depends largely upon the skill of the individual who wields it. Like all diagnostic tests, it has significant limitations and cannot substitute for a careful history and exercise of good judgment. Nonetheless, in skilled hands, it provides unique and vital information in many patients, and enhances our understanding of their condition.
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Affiliation(s)
- Jyoti Pillai
- Department of Neurology, Drexel College of Medicine, Philadelphia, Pennsylvania, USA
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Abstract
Dental practitioners from time to time must treat patients with epilepsy or similar seizure disorders. This article describes the various classification for epilepsy, explains how such disorders are evaluated and diagnosed, discusses management methods, and addresses related issues for special populations, such as pregnant women and elderly. In addition, the article offers information about what special steps dentists should take in treating such epileptic patients and others vulnerable to seizures and in preparing offices and staff for the possibility that a patient will have a seizure in the office. In general, a patient with severe, poorly controlled epilepsy should be treated in a hospital. Otherwise, a well-controlled patient should easily be treated in the office.
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Affiliation(s)
- Robert B Bryan
- Department of Oral and Maxillofacial Surgery, University of Oklahoma Health Sciences Center, College of Dentistry, 1201 N. Stonewall, Oklahoma City, OK 73117, USA.
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Abstract
Despite the fact that clinical characteristics of frontal lobe seizures have been recently described better, differentiating seizures of frontal lobe origin from NES on clinical grounds alone is difficult. The difficulty has been compounded by the fact that both inter-ictal and ictal EEG can be normal or nonspecific, and the same is true of imaging studies. A detailed clinical history as well as video monitoring can be helpful diagnostic tools. A multidisciplinary approach is warranted and is at times essential to improve the diagnosis and care of these difficult patients.
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Affiliation(s)
- Barbara C Jobst
- Section of Neurology, Dartmouth Epilepsy Program, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
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Abstract
Electroencephalography (EEG) continues to be the most important diagnostic tool in the management of patients with epilepsy. In particular, the high specificity of interictal epileptiform discharges makes scalp EEG a valuable tool in the evaluation of patients with a history of seizures or seizure-like episodes. Advances in technology, most notably the development of digital video-EEG, have significantly expanded the utility of EEG. In addition to the routine EEG, long-term monitoring studies including video-EEG, ambulatory EEG, and continuous EEG monitoring play important roles in various aspects of the diagnosis and treatment of epilepsy. Recent developments in computerized seizure detection and prediction algorithms, particularly those utilizing intracranial EEG electrodes, hold promise for future development of novel treatment strategies.
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Affiliation(s)
- Anil Mendiratta
- Department of Neurology, College of Physicians and Surgeons of Columbia University, 710 West 168th Street, Box 213, New York, NY 10032, USA.
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Affiliation(s)
- Donald L Schomer
- Comprehensive Epilepsy Program, Beth Israel Deaconess Medical Center, Baker 504, 330 Brookline Avenue, Boston, MA 02215, USA.
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Worrell GA, Lagerlund TD, Buchhalter JR. Role and limitations of routine and ambulatory scalp electroencephalography in diagnosing and managing seizures. Mayo Clin Proc 2002; 77:991-8. [PMID: 12233935 DOI: 10.4065/77.9.991] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The scalp electroencephalogram (EEG) is the cornerstone in the diagnosis and treatment of seizure disorders. The EEG, with its excellent temporal resolution, provides a direct measurement of cortical electrophysiology, revealing, for example, the presence of interictal epileptiform discharges that identify regions of an epileptogenic brain. We define the EEG characteristics of focal and generalized epileptiform discharges and provide evidence for their varying diagnostic importance in different patient populations. Identification of nonepileptiform EEG transients, such as wicket waves, small sharp spikes,rhythmic temporal theta activity, and 14- and 6-Hz positive bursts, that can be confused for epileptiform transients is emphasized. A final point is that the clinician must interpret EEG findings within the overall clinical context.
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Kissani N, Alarcon G, Dad M, Binnie CD, Polkey CE. Sensitivity of recordings at sphenoidal electrode site for detecting seizure onset: evidence from scalp, superficial and deep foramen ovale recordings. Clin Neurophysiol 2001; 112:232-40. [PMID: 11165524 DOI: 10.1016/s1388-2457(00)00531-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Some authors have recently stressed that the position of the tip of sphenoidal electrodes plays a crucial role in their efficacy in detecting ictal onset. An opportunity to test this hypothesis is provided by recordings from the most superficial contacts of foramen ovale (FO) electrode bundles because these contacts are located at the FO, in a position equivalent to that of optimally located sphenoidal electrodes. To simplify wording, recordings obtained by superficial FO electrodes will hereafter be called sphenoidal recordings, although they have not been obtained with standard sphenoidal electrodes. The sensitivities of simultaneous scalp and sphenoidal recordings for detecting ictal onset have been compared with each other, and with a 'gold standard' provided by simultaneous deep intracranial FO recordings from the mesial aspect of the temporal lobe. METHODS Three hundred and fourteen seizures obtained from 110 patients under telemetric presurgical assessment for temporal lobe epilepsy have been studied. Scalp electrodes included anterior temporal placements. All scalp electrodes were considered when identifying seizure onset but the anterior temporal electrodes were most frequently involved. RESULTS Ictal onset time at sphenoidal and scalp recordings: initial ictal changes appeared simultaneously in scalp and sphenoidal recordings in 123 seizures (39.2%). Initial changes occurred earlier in sphenoidal recordings in 63 seizures (20.1%), whereas they were seen earlier on the scalp in 76 seizures (24.2%). Artefacts prevented the comparison between sphenoidal and scalp recordings in 16 seizures (5.1%) and no ictal changes were seen on the scalp and/or sphenoidal recordings in 36 seizures (11.5%). In most of the 63 seizures where ictal changes appeared earlier in sphenoidal recordings, a delayed ipsilateral scalp onset was seen as the signal amplitude increased or scalp changes could be identified retrospectively on the scalp with an onset which appeared simultaneous and ipsilateral to the initial sphenoidal changes. Sphenoidal recordings supplied additional information when compared to scalp recordings in only 22 seizures (7%): in 5 seizures with artefacts on the scalp, in 6 seizures with no changes on the scalp and in 11 seizures with discrepant laterality at onset. Congruence in laterality with respect to deep intracraneal FO recordings: of the 61 seizures with unilateral onset on the scalp, onsets at sphenoidal recordings and deep FO electrodes were ipsilateral in most cases. In only 3 of these 61 seizures (4.9%), sphenoidal recordings lateralized ipsilateral to the deep FO electrodes in the presence of a contralateral onset on the scalp. In 14 among the 122 seizures (11.5%) with bilateral asymmetrical onset on the scalp, sphenoidal recordings lateralized seizure onset ipsilateral to the deep FO electrodes in the presence of a contralateral scalp onset. Thus, when compared with scalp EEG, sphenoidal recordings increased laterality congruence with respect to deep FO electrodes in 17 seizures (5.4%). CONCLUSIONS Extracranial electrodes located next to the FO at the sphenoidal electrode site yield an improvement over suitable surface electrodes in the identification of ictal onset in only 5.4-7% of seizures. Such improvement derives from the fact that the low amplitude signals often seen at seizure onset may show higher amplitude on sphenoidal than on scalp recordings.
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Affiliation(s)
- N Kissani
- Institute of Epileptology, King's College Hospital, Denmark Hill, SE5 9RS, London, UK
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Fernández Torre JL, Alarcón G, Binnie CD, Polkey CE. Comparison of sphenoidal, foramen ovale and anterior temporal placements for detecting interictal epileptiform discharges in presurgical assessment for temporal lobe epilepsy. Clin Neurophysiol 1999; 110:895-904. [PMID: 10400203 DOI: 10.1016/s1388-2457(99)00039-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Some authors have recently stressed that the position of the tip of the sphenoidal electrode plays a crucial role in its efficacy to detect mesio-basal spikes. We have tested this hypothesis by comparing the sensitivity of a contact of a foramen ovale bundle located at the foramen ovale (CFO) with scalp electrodes in detecting interictal epileptiform discharges. We have also compared deep and superficial foramen ovale contacts in the same bundle in order to establish whether deeper contacts can detect epileptiform discharges not seen at the foramen ovale or on the scalp. METHODS The sensitivity for detecting epileptiform discharges of simultaneous intracranial and scalp EEG recordings from 20 patients under telemetric presurgical assessment for temporal lobe epilepsy were compared. RESULTS Out of 2280 epileptiform discharges evaluated, about 70% were seen only at the deep foramen ovale contacts. Out of the 722 discharges recorded by CFO and/or scalp electrodes, 698 were seen at the CFO and 690 at the scalp anterior temporal electrode. Only on 29 occasions (4.15%) were discharges recorded at the CFO and not at the anterior temporal electrode. On 21 occasions (3.04%) CFO failed to detect discharges seen at the anterior temporal electrode. CONCLUSIONS Our findings confirm previous results suggesting that sphenoidal electrodes, however accurately positioned, offer no significant increase in detection sensitivity compared with anterior temporal scalp electrodes. In addition, these results confirm that a large proportion of discharges seen at the deepest foramen ovale contacts are not seen either on the scalp nor at the superficial foramen ovale contacts.
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Gambardella A, Pucci F, La Piane E, Messina D, Russo C, Zappia M, Oliveri RL, Quattrone A, Aguglia U. Usefulness of latero-orbital electrodes in detecting interictal epileptiform activity--a study of 60 patients with complex partial seizures. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1998; 107:174-6. [PMID: 9751288 DOI: 10.1016/s0013-4694(98)00049-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The use of latero-orbital (Lo) electrodes is a routine practice in any EEG laboratory to evaluate eye motion, but there are no data about their usefulness in revealing interictal epileptiform abnormalities. METHODS In 60 consecutive patients (27 men, 33 women, mean age 36.8 years, range 17-72) with complex partial seizures, we prospectively evaluated the utility of Lo electrodes in comparison with anterior temporal (AT) electrodes, for the detection of interictal epileptiform discharges (SW). RESULTS No epileptiform abnormality was seen in 4/60 patients. Both AT and Lo electrodes were significantly superior to 10-20 electrodes for detection of both patients and foci. Indeed, the standard 10-20 system alone allowed the detection of only 39 independent epileptiform foci in 35/56 (63%) patients, while AT and Lo electrodes were necessary for detection of 23 epileptiform foci in the remaining 21/56 (37%) patients. Importantly, there was no statistically significant difference in detection between AT and Lo electrodes. CONCLUSIONS Recordings from Lo electrodes are comparable to those from AT electrodes and are useful for localizing interictal temporal spiking activity. Lo electrodes may be substituted for basal electrodes in the day-to-day evaluation of patients with complex partial seizures.
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Affiliation(s)
- A Gambardella
- Institute of Neurology School of Medicine, Catanzaro, Italy.
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Schachter SC, Ito M, Wannamaker BB, Rak I, Ruggles K, Matsuo F, Wilner A, Jackel R, Gilliam F, Morris G, Skantz J, Sperling M, Buchhalter J, Drislane FW, Ives J, Schomer DL. Incidence of spikes and paroxysmal rhythmic events in overnight ambulatory computer-assisted EEGs of normal subjects: a multicenter study. J Clin Neurophysiol 1998; 15:251-5. [PMID: 9681563 DOI: 10.1097/00004691-199805000-00009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The incidences of spikes and paroxysmal rhythmic events (PREs) in 10-h overnight EEGs of normal adult volunteers (n=135) were studied at 11 sites with a computer-assisted ambulatory EEG monitoring system with automatic spike and PRE detection. Spikes were evident in the overnight EEG of 1 subject (0.7%), and PREs were apparent in the overnight EEG of the same subject (0.7%). The incidences of spikes of 24 other subjects with a history of migraine and/or a family history of epilepsy were 12.5 and 13.3%, respectively. The overnight EEGs of these subjects were significantly more likely to show spikes than the overnight EEGs of subjects without migraine or a family history of epilepsy.
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Affiliation(s)
- S C Schachter
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Barker R. Tachykinins, neurotrophism and neurodegenerative diseases: a critical review on the possible role of tachykinins in the aetiology of CNS diseases. Rev Neurosci 1996; 7:187-214. [PMID: 8916292 DOI: 10.1515/revneuro.1996.7.3.187] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The tachykinins are a family of undecapeptides that are widely distributed throughout the body, including the central nervous system (CNS). They have several well defined roles in non-CNS sites as well as in the dorsal horn, where they are involved in the transmission of nociceptive information. However their function(s) in other CNS sites is unclear, but there is some evidence that they function as neuromodulators rather than neurotransmitters. This neuromodulation includes a possible role in maintaining the integrity of neuronal populations, analogous to the functions of neurotrophic factors. This review critically evaluates the role of tachykinins as neurotrophic factors, with particular reference to the common neurodegenerative diseases of the CNS.
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Affiliation(s)
- R Barker
- National Hospital for Neurology and Neurosurgery, London, U.K
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Ives JR, Drislane FW, Schachter SC, Miles DK, Coots JF, Martin DL, McGuiggan JM, Schomer DL. Comparison of coronal sphenoidal versus standard anteroposterior temporal montage in the EEG recording of temporal lobe seizures. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1996; 98:417-21. [PMID: 8647045 DOI: 10.1016/0013-4694(96)95124-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Chronic sphenoidal electrodes were developed to facilitate the recording and localization of temporal lobe seizures during long term monitoring. Many reports demonstrate their utility in displaying temporal interictal epileptiform activity, but there have been few direct comparisons of sphenoidal electrodes and surface temporal recordings actually. We compared simultaneous portions of 74 EEG recordings of temporal lobe seizures (from 42 patients), with one portion including sphenoidal electrodes in a coronal montage and one with a standard anterior posterior temporal montage. Separated tracings were reviewed by readers blinded to the other portion of the tracing. The coronal sphenoidal montage allowed recognition of temporal lobe seizures inapparent with standard surface temporal electrodes in 19% of seizures and led to an earlier identification (usually by > or = 5 s) of the onset in 70% of seizures. Indwelling, flexible sphenoidal electrodes assist in ambulatory recording of temporal lobe seizures, both in demonstrating the presence of seizures and in determining the localization and time of seizure onset.
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Affiliation(s)
- J R Ives
- Department of Neurology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215, USA.
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Alving J. Extracranial EEG work-up in epilepsy surgery: usefulness and limitations. ACTA NEUROLOGICA SCANDINAVICA. SUPPLEMENTUM 1994; 152:5-8. [PMID: 8209656 DOI: 10.1111/j.1600-0404.1994.tb05176.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Extracranial interictal and ictal EEG provide essential information to diagnosis, seizure/syndrome classification and focus localization. Combined with structural and dynamic neuro-imaging and neuropsychological data, extracranial EEG will often provide sufficient information in preoperative work-up for temporal lobectomy. Ictal EEG recordings are essential to confirm the diagnosis and classification and, above all, to exclude patients with significant non-epileptic seizures from further surgical evaluation. The advantage of sphenoidal electrodes lies first and foremost in a more favorable signal/noise ratio, while their superiority to closely placed special scalp electrodes are more debatable.
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Affiliation(s)
- J Alving
- Dianalund Epilepsy Hospital, Denmark
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Jennum P, Dam M, Fuglsang-Frederiksen A. Effect of barbiturate on epileptiform activity: comparison between intravenous and oral administration. Sphenoidal, zygomatic and temporal recordings. Acta Neurol Scand 1993; 88:284-8. [PMID: 8256574 DOI: 10.1111/j.1600-0404.1993.tb04237.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The present study was performed in order to compare: 1) the differences between oral and intravenous barbiturate on interictal epileptiform activity (sharp-waves and spikes) in the EEG, and 2) interictal epileptiform activity in the sphenoidal electrode compared to the temporal and zygomatic electrodes (an electrode placed at the cutaneous entry of the sphenoidal electrode) during intravenous barbiturate administration in patients with epilepsy. Two procedures were performed: 1) an oral pentobarbital sleep induction with 10-20 electrode placement including a zygomatic electrode, and 2) an intravenous thiopental sleep induction with the same electrode placement including a sphenoidal electrode. Thirty eight patients with complex partial seizures were included. During the oral pentobarbital procedure 34 of 38 (90%) patients showed interictal epileptiform activity compared with 22 of 38 (55%) patients during the intravenous thiopental procedure (p < 0.005). A interictal epileptiform focus was observed in 33 (87%) patients in the oral procedure and in 19 (50%) patients in the intravenous procedure (p < 0.01). Interictal epileptiform activity recorded in the sphenoidal electrode was also recorded in the zygomatic electrode. Except from two patients a good correlation was observed between the zygomatic electrodes and the F7/F8 electrodes. We conclude that administration of intravenous thiopental offers no advantage compared to the administration of oral pentobarbital as an activating procedure, and for standard interictal EEG recordings with sleep activation procedures, suitable places scalp electrodes including a zygomatic electrode with the use of oral pentobarbital may be sufficient.
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Affiliation(s)
- P Jennum
- Department of Clinical Neurophysiology, Hvidovre Hospital, University of Copenhagen, Denmark
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Comparison of EEG derived from sphenoidal, infrazygomatic, anterior temporal, and midtemporal electrodes during complex partial seizures. ACTA ACUST UNITED AC 1993. [DOI: 10.1016/s0896-6974(05)80083-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chu NS. Surface sphenoidal electrode for recording anterior temporal spikes. CLINICAL EEG (ELECTROENCEPHALOGRAPHY) 1992; 23:190-5. [PMID: 1395057 DOI: 10.1177/155005949202300408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Spike analysis was performed to determine if surface sphenoidal electrodes were suitable substitutes for depth sphenoidal or anterior temporal electrodes in outpatient EEG recordings for the diagnosis of complex partial seizures of anterior temporal origin. Spike measurements consisted of spike detection rate, spike amplitude, and location of maximal amplitude spikes. Depth sphenoidal electrodes had the highest yield in these three measurements. Surface sphenoidal electrodes did not differ from anterior temporal electrodes in spike detection rate and spike amplitude, but the former recorded almost no maximal amplitude spikes, while the latter had approximately 30% of the maximal spikes. It is concluded that surface sphenoidal electrodes are slightly inferior to anterior temporal electrodes, but the differences between them are minimal for practical purposes in outpatient EEG recordings.
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Affiliation(s)
- N S Chu
- Department of Neurology, Chang Gung Medical College, Taipei, Taiwan
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36
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Goodin DS, Aminoff MJ, Laxer KD. Reply. Ann Neurol 1991. [DOI: 10.1002/ana.410290222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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37
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Stecker MM, Selzer ME. Editor's note. Ann Neurol 1991. [DOI: 10.1002/ana.410290223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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38
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Sadler RM, Blume WT. Multiple electroencephalograph electrodes for spike detection in partial complex seizures. Ann Neurol 1991; 29:224-6. [PMID: 2012392 DOI: 10.1002/ana.410290221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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