Abstract
Objective
Interictal occipital epileptiform abnormalities have not been well characterized. The objective of this pilot study was to assess their significance in children.
Methods
A search was performed on the EEG database for the keywords “occipital”, “spike”, “sharp wave” and “epileptiform”. Patients were divided into two groups based on the absence of all (group 1) or presence of any (group 2) of the following criteria: mental retardation, cerebral palsy, neurological deficits, abnormal MRI and/or intractable epilepsy. Special attention was given to the spike/sharp wave amplitude/duration and background slowing.
Results
A total of 44 children (eight months to 15 years) were studied. Groups 1 and 2 were each composed of 22 children. Background slowing was more frequent in group 2 (10/22, 45%) compared to group 1 (1/22, 4.5%; p = 0.002). In group 2, 8/22 (36%) had spikes or sharp waves with amplitudes below 50 μV or above 150 μV with a positive predictive value of 89%, and a negative predictive value of 39%. Only 1/22 (4.5%) in group 1 had epileptiform activity outside of the 50–150 μV range.
Conclusions
The presence of very high or low-amplitude occipital epileptiform abnormalities or background slowing may be indicative of encephalopathy.
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References
Ajmone-Marsan C, Ralston BL. The epileptic seizure: its functional morphology and diagnostic significance. Springfield, IL: Charles C. Thomas, 1957.
Beaumanoir A, Ballis T, Varfis G, Ansari K. Benign epilepsy of childhood with Rolandic spikes. A clinical, electroencephalographic, and telencephalographic study. Epilepsia 1974; 15: 301–315.
Blume WT. Occipital lobe epilepsies. In: Lüders H, ed. Epilepsy surgery. New York: Raven Press, 1991: 167–171.
Caraballo R, Sologuestua A, Ruggieri VL, et al. Clinical and electroencephalographic aspects of late infantile neuronal ceroid lipofuscinosis. Rev Neurol 2005; 40: 135–140.
Chahine LM, Mikati MA. Benign pediatric localization-related epilepsies. Epileptic Disord 2006; 8: 243–258.
Curatolo P, Seri S, Verdecchia M, Bombardieri R. Infantile spasms in tuberous sclerosis complex. Brain Dev 2001; 23: 502–507.
Dan B, Boyd SG. Angelman syndrome reviewed from a neurophysiological perspective. The UBE3A-GABRB3 hypothesis. Neuropediatrics 2003; 34: 169–176.
De Romanis F, Feliciani M, Cerbo R. Migraine and other clinical syndromes in children affected by EEG occipital spike-wave complexes. Funct Neurol 1988; 3: 187–203.
Ebersole JS, Pedley TA. Current Practice of Clinical Electroencephalography. Philadelphia: Lippincott Williams & Wilkins, 2003.
Engel Jr J. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia 2001; 42: 796–803.
Gastaut H. A new type of epilepsy: benign partial epilepsy of childhood with occipital spike-waves. Clin Electroencephalogr 1982; 13: 13–22.
Hughes JR, DeLeo AJ, Melyn MA. The Electroencephalogram in Attention Deficit-Hyperactivity Disorder: Emphasis on Epileptiform Discharges. Epilepsy Behav 2000; 1: 271–277.
Kacinski M, Kostyk E, Kruczek A, Skowronek-Bala B. Epilepsy in three children with Wolf-Hirschhorn syndrome. Przegl Lek 2005; 62: 1298–1301.
Kagitani-Shimono K, Imai K, Otani K, et al. Epilepsy in Wolf-Hirschhorn syndrome (4p-). Epilepsia 2005; 46: 150–155.
Kellaway P. The incidence, significance and natural history of spike foci in children. In: Henry CE, ed. Current clinical neurophysiology. New York: Elsevier/North Holland, 1980: 151–75.
Koutroumanidis M. Panayiotopoulos syndrome: an important electroclinical example of benign childhood system epilepsy. Epilepsia 2007; 48: 1044–1053.
Laan LA, Vein AA. Angelman syndrome: is there a characteristic EEG? Brain Dev 2005; 27: 80–87.
Lada C, Skiadas K, Theodorou V, Loli N, Covanis A. A study of 43 patients with panayiotopoulos syndrome, a common and benign childhood seizure susceptibility. Epilepsia 2003; 44: 81–88.
Lerman P, Kivity S. The benign partial nonrolandic epilepsies. J Clin Neurophysiol 1991; 8: 275–287.
Lerman P. Benign partial epilepsy with centrotemporal spikes. In: Roger J, Bureau M, Dravet C, Dreifuss FE, Perret A, Wolf P, eds. Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1992: 189–200.
Loiseau P. Benign focal epilepsies of childhood. In: Wyllie E, ed. The treatment of epilepsy: principles and practices. Philadelphia: Lea and Febiger, 1993: 503–511.
Ludwig BI, Marsan CA. Clinical ictal patterns in epileptic patients with occipital electroencephalographic foci. Neurology 1975; 25: 463–471.
Martinovic Z. Panayiotopoulos syndrome. Lancet 2001; 358: 69.
Parisi P, Villa MP, Pelliccia A, Rollo VC, Chiarelli F, Verrotti A. Panayiotopoulos syndrome: diagnosis and management. Neurol Sci 2007; 28: 72–79.
Silvestri R, Gagliano A, Calarese T, et al. Ictal and interictal EEG abnormalities in ADHD children recorded over night by videopolysomnography. Epilepsy Res 2007; 75: 130–137.
So N, Berkovic S, Andermann F, Kuzniecky R, Gendron D, Quesney LF. Myoclonus epilepsy and ragged-red fibres (MERRF). 2. Electrophysiological studies and comparison with other progressive myoclonus epilepsies. Brain 1989; 112(Pt 5): 1261–1276.
Tedrus GM, Fonseca LC. Autonomic seizures and autonomic status epilepticus in early onset benign childhood occipital epilepsy (Panayiotopoulos syndrome). Arq Neuropsiquiatr 2006; 64: 723–726.
Van Ness PC. Frontal and parietal lobe epilepsy. In: Wyllie E, ed. The treatment of epilepsy: principles and practices. Philadelphia: Lea and Febiger, 1993: 525–532.
Vigevano F, Fusco L, Pachatz C. Neurophysiology of spasms. Brain Dev 2001; 23: 467–472.
Watanabe Y, Ogihara M, Hoshika A. Cluster of epileptic spasms preceded by focal seizures observed in localization-related epilepsy. Brain Dev 2007; 29: 571–576.
Westmoreland BF. The EEG findings in extratemporal seizures. Epilepsia 1998; 39(Suppl 4): S1–S8.
Williamson PD, Spencer DD, Spencer SS, Novelly RA, Mattson RH. Complex partial seizures of frontal lobe origin. Ann Neurol 1985; 18: 497–504.
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Wang, C., Khurana, D.S., Kothare, S.V. et al. Significance of interictal occipital epileptiform discharges in children. Epileptic Disord 12, 59–64 (2010). https://doi.org/10.1684/epd.2010.0296
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DOI: https://doi.org/10.1684/epd.2010.0296