Study on concordance of ictal and interictal epileptiform activity in patients with tuberous sclerosis complex / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the relationship between the ictal onset zone and dominant interictal epileptiform foci in tuberous sclerosis complex (TSC) patients.</p><p><b>METHOD</b>Clinical data of 20 patients with TSC which had epileptic seizures during Video-EEG monitoring was assessed. Consistency and dominance of focal interictal epileptiform activity and the ictal onset zone were identified. Concordance between interictal and ictal findings was analyzed.</p><p><b>RESULT</b>Of the 20 patients, 7 were female, and 13 were male. The age of epilepsy onset was from 15 d to 6 years. The Video-EEG monitoring age was from 6 months to 11 years. Family history was found in three cases. Abnormality in neuroimaging existed in 17 of 18 patients who were examined. Interictal EEG showed hypsarrhythmia in 3 patients, multifocal epileptiform activity with a dominant focus in 12 patients, both focal and generalized discharges in 2 patients, and only focal discharges in 3 patients. The seizures types during EEG monitoring included epileptic spasms, partial seizure, atypical absence, and generalized or focal myoclonic seizure. The most common seizure type was partial seizure and then epileptic spasms. EEG in 4 patients with epileptic spasms showed ictal generalized discharges and interictal hypsarrhythmia or generalized discharges. Clinical manifestation of epileptic spasms was asymmetric in 3 patients. Lateralization and location of interictal and ictal discharges were consistent in 2 of the 3 patients, while only lateralization consistency in 1 of the 3 patients. Partial seizures as the only seizure type were monitored in 13 patients. Of the 13 patients, lateralization and location of interictal and ictal discharges were inconsistent in 2 patients (15%), consistent in 8 patients (62%), lateralization or location consistent in 2 patients (15%). One case could not be analyzed because of uncertainty of lateralization and location of seizure onset.</p><p><b>CONCLUSION</b>In the majority of patients with TSC, multifocal interictal epileptiform activity is present, in which a most dominance of focal epileptiform activity could be found. For some epileptic seizures or the majority of partial seizures, the ictal onset zone is concordant with the dominance of focal interictal epileptiform foci. The concordance might have positioning reference significance for preoperative evaluation of epilepsy surgery.</p>

Value of video electroencephalogram in the identification of neonatal epileptic and non-epileptic seizures / 中华围产医学杂志

Objective To evaluate the clinical effectiveness of video electroencephalogram (VEEG) in neonatal seizure. Methods Seizures attacks of 64 newborns with gestational ages 28-44 weeks were monitored by VEEG. Results Incidence of abnormal VEEG was 32. 8%. Among 64 cases found in the VEEG, 13 cases had epileptic discharge in the ictal VEEGs. Three cases showed epileptic discharge in the interictal VEEGs with normal background rhythm. Two cases presented epileptic discharge in the interictal VEEGs with abnormal background rhythm. Three cases had abnormal background rhythm only. Discharge frequency during sleeping was more quick than that during awake-ness, mostly in the quiet sleep phase. Most frequently ictal epileptic discharges were a focal onset (16/ 18) , and 13 cases happened in the temple lobe. No epileptic discharge in the ictal and interictal VEEGs were tested in 46 cases attacked with seizures, which were diagnosed as non-epileptic seizures. Conclusions VEEG plays an important role in the diagnosis and differential diagnosis in epilepsy and non-epileptic seizure in newborns, and is valuable to perform early to improve prognosis.