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Fincham GW, Kartar A, Uthaug MV, Anderson B, Hall L, Nagai Y, Critchley H, Colasanti A. High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications. Neurosci Biobehav Rev 2023; 155:105453. [PMID: 37923236 DOI: 10.1016/j.neubiorev.2023.105453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
High Ventilation Breathwork (HVB) refers to practices employing specific volitional manipulation of breathing, with a long history of use to relieve various forms of psychological distress. This paper seeks to offer a consolidative insight into potential clinical application of HVB as a treatment of psychiatric disorders. We thus review the characteristic phenomenological and neurophysiological effects of these practices to inform their mechanism of therapeutic action, safety profiles and future clinical applications. Clinical observations and data from neurophysiological studies indicate that HVB is associated with extraordinary changes in subjective experience, as well as with profound effects on central and autonomic nervous systems functions through modulation of neurometabolic parameters and interoceptive sensory systems. This growing evidence base may guide how the phenomenological effects of HVB can be understood, and potentially harnessed in the context of such volitional perturbation of psychophysiological state. Reports of putative beneficial effects for trauma-related, affective, and somatic disorders invite further research to obtain detailed mechanistic knowledge, and rigorous clinical testing of these potential therapeutic uses.
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Affiliation(s)
- Guy W Fincham
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK; University of Sussex, School of Psychology, Brighton, UK.
| | - Amy Kartar
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Malin V Uthaug
- The Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, UK; Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, The Netherlands
| | - Brittany Anderson
- University of Wisconsin School of Medicine & Public Health, Department of Psychiatry, University of Wisconsin-Madison, USA
| | - Lottie Hall
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Yoko Nagai
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Hugo Critchley
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK
| | - Alessandro Colasanti
- Brighton & Sussex Medical School, Department of Neuroscience, University of Sussex, UK; Sussex Partnership NHS Foundation Trust.
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Salvati KA, Souza GMPR, Lu AC, Ritger ML, Guyenet P, Abbott SB, Beenhakker MP. Respiratory alkalosis provokes spike-wave discharges in seizure-prone rats. eLife 2022; 11:72898. [PMID: 34982032 PMCID: PMC8860449 DOI: 10.7554/elife.72898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/03/2022] [Indexed: 12/13/2022] Open
Abstract
Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable hyperventilation to powerfully activate absence seizure-generating circuits remain entirely unknown. By utilizing gas exchange manipulations and optogenetics in the WAG/Rij rat, an established rodent model of absence epilepsy, we demonstrate that absence seizures are highly sensitive to arterial carbon dioxide, suggesting that seizure-generating circuits are sensitive to pH. Moreover, hyperventilation consistently activated neurons within the intralaminar nuclei of the thalamus, a structure implicated in seizure generation. We show that intralaminar thalamus also contains pH-sensitive neurons. Collectively, these observations suggest that hyperventilation activates pH-sensitive neurons of the intralaminar nuclei to provoke absence seizures.
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Affiliation(s)
- Kathryn A Salvati
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - George M P R Souza
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Adam C Lu
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - Matthew L Ritger
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - Patrice Guyenet
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Stephen B Abbott
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Mark P Beenhakker
- Department of Pharmacology, University of Virginia, Charlottesville, United States
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3
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Mattozzi S, Cerminara C, Sotgiu MA, Carta A, Coniglio A, Roberto D, Simula DM, Luca Pruneddu G, Dell'Avvento S, Muzzu SS, Fadda M, Luzzu GM, Sotgiu S, Casellato S. Occurrence of hyperventilation-induced high amplitude rhythmic slowing with altered awareness after successful treatment of typical absence seizures and a network hypothesis. Clin Neurophysiol Pract 2021; 6:185-188. [PMID: 34258479 PMCID: PMC8255168 DOI: 10.1016/j.cnp.2021.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022] Open
Abstract
We show that typical absence seizures (AS) and hyperventilation-induced high amplitude rhythmic slowing (HIHARS) or HIHARS with Altered Awareness (HIHARSAA) can coexist in the same patient, but never at the same time. We found that alkalosis and dysfunction of the same neural network are involved in both AS and HIHARS. AS and HIHARS should be better recognized to avoid misdiagnosis and overtreatment. AS and HIHARS can coexist in the same patient, but never at the same time.
Background Typical absence seizures (AS) are epileptic phenomena typically appearing in children 4–15 years of age and can be elicited by hyperventilation (HV). Hyperventilation-induced high-amplitude rhythmic slowing (HIHARS) represents a paraphysiological response during HV and may manifest with alteration of awareness (HIHARSAA). To date, HIHARSAA has mostly been described in patients without epilepsy. Aim To describe five patients with treatment-responsive typical AS who, after becoming seizure free, presented with HIHARSAA. Methods By using video-electroencephalographic recording (Video-EEG), we describe differential clinical characteristics and ictal electrophysiological patterns of both typical AS and HIHARSAA. Results We demonstrate that when HIHARSAA occurs in patients with typical AS there is a temporal window between the two phenomena. This suggests that the presence of typical AS precludes the appearance of HIHARSAA. Conclusions We hypothesize that alkalosis and dysfunction of the same neural network are involved in both typical AS and HIHARSAA and that their distinct electroclinic manifestations are due to the involvement of different ion channels. Significance A better understanding of the characteristics of typical AS and HIHARSAA and of the role of alkalosis in both, can help avoiding misdiagnosis and identifying more suitable therapies for typical AS.
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Affiliation(s)
- Simone Mattozzi
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Caterina Cerminara
- Department of Neurosciences, Pediatric Neurology Unit (PNU), Tor Vergata University of Rome, Italy
| | - Maria A Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Carta
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Antonella Coniglio
- Department of Neurosciences, Pediatric Neurology Unit (PNU), Tor Vergata University of Rome, Italy
| | - Denis Roberto
- Department of Neurosciences, Pediatric Neurology Unit (PNU), Tor Vergata University of Rome, Italy
| | - Delia M Simula
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Gian Luca Pruneddu
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Silvia Dell'Avvento
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - S Sonia Muzzu
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Maria Fadda
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Giovanni M Luzzu
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Stefano Sotgiu
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Susanna Casellato
- Section of Child Neuropsychiatry, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
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Acharya JN, Acharya VJ. Hyperventilation-induced EEG slowing with altered awareness: Non-epileptic, epileptic or both? Clin Neurophysiol Pract 2021; 6:189-190. [PMID: 34258480 PMCID: PMC8255167 DOI: 10.1016/j.cnp.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 10/31/2022] Open
Affiliation(s)
- Jayant N. Acharya
- Department of Neurology, Penn State University Hershey Medical Center, Hershey, PA, USA
| | - Vinita J. Acharya
- Department of Neurology, Penn State University Hershey Medical Center, Hershey, PA, USA
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Panda PK, Sharawat IK. Seizure provocation and hyperventilation: Does position matter? Seizure 2020; 83:264-265. [DOI: 10.1016/j.seizure.2020.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 11/26/2022] Open
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Nasreddine W, Fakhredin M, Makke Y, Hmaimess G, Sabbagh S, Beaini S, El Tourjuman O, Beydoun A. Hyperventilation-induced high-amplitude rhythmic slowing: A mimicker of absence seizures in children. Epilepsy Behav 2020; 103:106510. [PMID: 31645312 DOI: 10.1016/j.yebeh.2019.106510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE Hyperventilation (HV) in children can lead to HV-induced high-amplitude rhythmic slowing (HIHARS) on the EEG (electroencephalogram) which is sometimes associated with altered awareness (AA) and concomitant semiological features. Our aims were to determine the frequency of HIHARS in children, to assess if the associated semiological features were temporally related to HV, and to evaluate if specific semiological features can differentiate HIHARS with AA from absence seizures. METHODS Consecutive children with suspected new onset seizure(s) underwent HV and awareness testing during video-EEG acquisition. Hyperventilation-induced high-amplitude rhythmic slowing was defined as 2.5- to 5-Hz generalized rhythmic slowing with amplitude ≥100 μv lasting for ≥3 s. The associated semiological features were compared between the group of children with HIHARS and AA, an age- and gender-matched control group without HIHARS, and in children who experienced absence seizures during HV. RESULTS One hundred sixteen children with a mean age of 9.8 years were included. Hyperventilation-induced high-amplitude rhythmic slowing occurred in 39 children (33.6%) with AA documented in 30 (76.9%). The probability of developing AA during HIHARS was significantly and positively correlated with the HIHARS duration. The frequencies of HIHARS were not significantly different between children diagnosed with seizure(s) and those with nonepileptic spells. Hyperventilation cessation and staring did not occur in any child of the control group. Fidgeting and yawning were significantly more common in the group with HIHARS with AA while staring and blinking were significantly more frequent in the group of children with absence seizures. CONCLUSIONS We ascertained that HIHARS with AA is a relatively common occurrence in children and most likely represents an age-related nonepileptic phenomenon. When associated with fidgeting or yawning, it can help differentiate this phenomenon from absence seizures. However, recording the concomitant presence of generalized spike wave discharges on the EEG remains essential to confirm the diagnosis of absence seizures.
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Affiliation(s)
- Wassim Nasreddine
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Fakhredin
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yamane Makke
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Ghassan Hmaimess
- Department of Pediatrics, St George Hospital Medical University Center, University of Balamand, Beirut, Lebanon
| | - Sandra Sabbagh
- Department of Pediatrics, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Shawkat Beaini
- Department of Internal Medicine, Ain Wazein Medical Village, Chouf, Lebanon
| | | | - Ahmad Beydoun
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
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Salvati KA, Beenhakker MP. Out of thin air: Hyperventilation-triggered seizures. Brain Res 2017; 1703:41-52. [PMID: 29288644 DOI: 10.1016/j.brainres.2017.12.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/29/2017] [Accepted: 12/27/2017] [Indexed: 12/11/2022]
Abstract
Voluntary hyperventilation triggers seizures in the vast majority of people with absence epilepsy. The mechanisms that underlie this phenomenon remain unknown. Herein, we review observations - many made long ago - that provide insight into the relationship between breathing and absence seizures.
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Affiliation(s)
- Kathryn A Salvati
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA 22903, United States
| | - Mark P Beenhakker
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA 22903, United States.
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Al-Rawas SF, Poothrikovil RP, Abdelbasit KM, Delamont RS. The Correlation between Electroencephalography Amplitude and Interictal Abnormalities: Audit study. Sultan Qaboos Univ Med J 2014; 14:e473-e477. [PMID: 25364549 PMCID: PMC4205058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/09/2014] [Accepted: 05/15/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES The aim of this study was to establish the relationship between background amplitude and interictal abnormalities in routine electroencephalography (EEG). METHODS This retrospective audit was conducted between July 2006 and December 2009 at the Department of Clinical Physiology at Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A total of 1,718 electroencephalograms (EEGs) were reviewed. All EEGs were from patients who had been referred due to epilepsy, syncope or headaches. EEGs were divided into four groups based on their amplitude: group one ≤20 μV; group two 21-35 μV; group three 36-50 μV, and group four >50 μV. Interictal abnormalities were defined as epileptiform discharges with or without associated slow waves. Abnormalities were identified during periods of resting, hyperventilation and photic stimulation in each group. RESULTS The mean age ± standard deviation of the patients was 27 ± 12.5 years. Of the 1,718 EEGs, 542 (31.5%) were abnormal. Interictal abnormalities increased with amplitude in all four categories and demonstrated a significant association (P <0.05). A total of 56 EEGs (3.3%) had amplitudes that were ≤20 μV and none of these showed interictal epileptiform abnormalities. CONCLUSION EEG amplitude is an important factor in determining the presence of interictal epileptiform abnormalities in routine EEGs. This should be taken into account when investigating patients for epilepsy. A strong argument is made for considering long-term EEG monitoring in order to identify unexplained seizures which may be secondary to epilepsy. It is recommended that all tertiary institutions provide EEG telemetry services.
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Affiliation(s)
- Sami F. Al-Rawas
- Department of Clinical Physiology, Sultan Qaboos University Hospital
| | | | - Khidir M. Abdelbasit
- Department of Mathematics & Statistics, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Robert S. Delamont
- Department of Neurology, Institute of Epileptology, King’s College Hospital, London, UK
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Barker A, Ng J, Rittey CDC, Kandler RH, Mordekar SR. Outcome of children with hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness. Dev Med Child Neurol 2012; 54:1001-5. [PMID: 22712871 DOI: 10.1111/j.1469-8749.2012.04337.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness (HIHARS) is increasingly being identified in children and is thought to be an age-related non-epileptic electrographic phenomenon. We retrospectively investigated the clinical outcome in 15 children (six males, nine females) with HIHARS (mean age 7y, SD 1y 11mo; range 4y 6mo-11y). The presenting feature in 11 cases was blank spells - two of these children also had generalized tonic-clonic seizures (GTCS) - and in one individual the main concern was deteriorating school performance. Three children had symptoms suggestive of focal motor seizures. Of the nine children presenting solely with blank spells, further follow-up (mean duration 18mo, SD 21mo) revealed full resolution of symptoms in six, but three had persistent symptoms. In our study, the symptoms of children with HIHARS presenting with blank spells in isolation appeared to resolve spontaneously and did not evolve into convulsive seizures or other paroxysmal events considered to be clearly epileptic. Children (with HIHARS) who presented with clinical features suggestive of GTCS or focal motor seizures (with or without blank spells) and/or had epileptiform discharges on interictal electroencephalography were subsequently diagnosed with epilepsy.
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Affiliation(s)
- Alexander Barker
- Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield, UK
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The efficacy of routine hyperventilation for seizure activation during prolonged video-electroencephalography monitoring. J Clin Neurosci 2010; 17:1503-5. [PMID: 20833049 DOI: 10.1016/j.jocn.2009.12.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 12/17/2009] [Accepted: 12/20/2009] [Indexed: 11/22/2022]
Abstract
Hyperventilation (HV) is considered to be one of the activation procedures that provokes epileptic potentials and clinical seizures. However, the true clinical yield of HV is not well established. We retrospectively reviewed the records of all patients admitted to JFK Hospital, Edison, New Jersey, between October 2001 and December 2004 for long-term video-electroencephalography (EEG). A total of 475 patients (193 males; 282 females; age range 5-89 years) were included in the study. All patients underwent routine 3-minute HV as part of the evaluation of their clinical episodes. During the initial assessment, 165 patients did not experience a seizure event, 92 had non-epileptic events, 16 experienced psychogenic non-epileptic seizures (PNES) and six had a clinical event. During HV, of the 43 patients who had primary generalized epilepsy, nine had an abnormal EEG and two experienced seizures; however, out of the 159 patients who had partial seizures, only one patient demonstrated an abnormal EEG. Our study demonstrates that routine HV generally has a very low yield in our Epilepsy-Monitoring Unit. This finding also lends support to the idea that partial seizures are relatively resistant to HV activation.
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Koutroumanidis M, Bourvari G, Tan SV. Idiopathic generalized epilepsies: clinical and electroencephalogram diagnosis and treatment. Expert Rev Neurother 2006; 5:753-67. [PMID: 16274333 DOI: 10.1586/14737175.5.6.753] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This review concentrates on the principles of the clinical and electroencephalogram diagnosis of idiopathic generalized epilepsies and their treatment. The electroclinical variability of the main seizure types is detailed and particular emphasis is placed on the differential diagnosis from other seizures and nonepileptic conditions that is essential for the optimal management of these patients. The authors review the various idiopathic generalized epilepsy subsyndromes and conditions that are included in both the 1989 International League Against Epilepsy classification system and the recently proposed International League Against Epilepsy scheme, but also syndromes and forms that have not been formally recognized. Finally, the authors describe the principles of antiepileptic drug treatment with the old and newer drugs, and their specific indications and contraindications in the various syndromes and seizure types.
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Affiliation(s)
- Michael Koutroumanidis
- Department of Clinical Neurophysiology and Epilepsies, Lambeth Wing, 3rd Floor, St Thomas' Hospital, London SE1 7EH, UK.
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Koutroumanidis M, Smith S. Use and Abuse of EEG in the Diagnosis of Idiopathic Generalized Epilepsies. Epilepsia 2005; 46 Suppl 9:96-107. [PMID: 16302882 DOI: 10.1111/j.1528-1167.2005.00320.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article concentrates on the role of electroencephalograms (EEGs) in the diagnosis and management of patients with idiopathic generalized epilepsies (IGEs). We review the morphologic and behavioral characteristics of the interictal and ictal EEG markers of IGE that should guide recording strategies to augment its diagnostic yield, and we attempt to delineate those particular features that may be relevant to different IGE syndromes. We also explore the electrographic boundaries between IGEs and cryptogenic/symptomatic generalized and focal epilepsies, and focal/secondary generalized epilepsies, with particular relevance to the phenomena of focal abnormalities and secondary bilateral synchrony, commenting on possible diagnostic pitfalls and areas of uncertainty.
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Affiliation(s)
- Michael Koutroumanidis
- Department of Clinical Neurophysiology and Epilepsies, St Thomas' Hospital, London, United Kingdom.
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Mäkiranta MJ, Ruohonen J, Suominen K, Sonkajärvi E, Salomäki T, Kiviniemi V, Seppänen T, Alahuhta S, Jäntti V, Tervonen O. BOLD-contrast functional MRI signal changes related to intermittent rhythmic delta activity in EEG during voluntary hyperventilation-simultaneous EEG and fMRI study. Neuroimage 2004; 22:222-31. [PMID: 15110012 DOI: 10.1016/j.neuroimage.2004.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2003] [Revised: 12/24/2003] [Accepted: 01/05/2004] [Indexed: 10/26/2022] Open
Abstract
Differences in the blood oxygen level dependent (BOLD) signal changes were studied during voluntary hyperventilation (HV) between young healthy volunteer groups, (1) with intermittent rhythmic delta activity (IRDA) (N = 4) and (2) controls (N = 4) with only diffuse arrhythmic slowing in EEG (normal response). Subjects hyperventilated (3 min) during an 8-min functional MRI in a 1.5-T scanner, with simultaneous recording of EEG (successful with N = 3 in both groups) and physiological parameters. IRDA power and average BOLD signal intensities (of selected brain regions) were calculated. Hypocapnia showed a tendency to be slightly lighter in the controls than in the IRDA group. IRDA power increased during the last minute of HV and ended 10-15 s after HV. The BOLD signal decreased in white and gray matter after the onset of HV and returned to the baseline within 2 min after HV. The BOLD signal in gray matter decreased approximately 30% more in subjects with IRDA than in controls, during the first 2 min of HV. This difference disappeared (in three subjects out of four) during IRDA in EEG. BOLD signal changes seem to depict changes, which precede IRDA. IRDA due to HV in healthy volunteers represent a model with a clearly defined EEG pattern and an observable BOLD signal change.
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Affiliation(s)
- Minna J Mäkiranta
- Department of Clinical Neurophysiology, Oulu University Hospital, University of Oulu, Kajaanintie 50, 90220 Oulu, Finland.
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