Wavelet entropy analysis for ictal electroencephalogram signals of child absence epilepsy / 生物医学工程学杂志

The integral and individual-scale wavelet entropy of electroencephalogram (EEG) were employed to investigate the information complexity in EEG and to explore the dynamic mechanism of child absence epilepsy (CAE). The digital EEG signals were collected from patients with CAE and normal controls. Time-frequency features were extracted by continuous wavelet transformation. Individual scale power spectrum characteristics were represented by wavelet-transform. The integral and individual-scale wavelet entropy of EEG were computed on the basis of individual scale power spectrum. The evolutions of wavelet entropy across ictal EEG of CAE were investigated and compared with normal controls. The integral wavelet entropy of ictal EEG is lower than inter-ictal EEG for CAE, and it also lower than normal controls. The individual-scale wavelet entropies of 12th scale (centered at 3 Hz) of ictal EEG in CAE was significantly higher than normal controls. The individual-scale wavelet entropies for α band (centered at 10 Hz) of ictal EEG in CAE were much lower than normal controls. The integral wavelet entropy of EEG can be considered as a quantitative parameter of complexity for EEG signals. The complexity of ictal EEG for CAE is obviously declined in CAE. The wavelet entropies declined could become quantitative electrophysiological parameters for epileptic seizures, and it also could provide a theoretical basis for the study of neuromodulation techniques in epileptic seizures.

Transient Abnormalities on Magnetic Resonance Imaging after Absence Seizures / 대한소아신경학회지

Magnetic resonance imaging (MRI) is recommended for patients with epileptic seizures to rule out an underlying focal lesion. However, abnormalities in idiopathic generalized epilepsy, including childhood absence epilepsy, cannot usually be identified using brain imaging modalities such as MRI. Peri-ictal MRI abnormalities have been most commonly reported secondary to status epilepticus and are rarely observed in patients with focal seizures and generalized tonic-clonic seizures. Transient peri-ictal MRI abnormalities in absence epilepsy are extremely rare. A five-year-old girl presented with a three-day history of absence seizures that persisted despite continued treatment with sodium valproate. Electroencephalography showed bursts of generalized 3-Hz spike-and-wave discharges, during and after hyperventilation. Abnormal cortex thickening in the left perisylvian region was detected on T2-weighted brain MRI, and cortical dysplasia or a tumor was suspected. The patient started treatment with lamotrigine and was seizure-free after one month. The abnormal MRI lesion was completely resolved at the two-month follow-up. We report on a patient with childhood absence epilepsy and reversible brain MRI abnormalities in the perisylvian region. To our knowledge, this is the first report of transient MRI abnormalities after absence seizures. Transient peri-ictal MRI abnormalities should be considered for differential diagnosis in patients with absence seizures and a focal abnormality on brain MRI.

Genetic progress of childhood absence epilepsy / 上海交通大学学报（医学版）

Childhood absence epilepsy (CAE) is an important kind of epileptic syndrome of genetic generalized epilepsies (GGEs) with prevalence of 5.8/100 000-7.1/100 000. The genetic mechanism of CAE is always the hotspot of research. Susceptibility genes including calcium channel and γ-aminobutyric acid receptor as well as copy number variations (CNVs) have been found. However, those mechanisms cannot explain all the situations since the genetic content of CAE is rather complicated. Nowadays, with new susceptibility genes and genetic mechanisms coming to light, researchers are supposed to study this problem from the point of associated epileptic syndromes. In this review, the genetic features, probable mechanisms of CAE and therapeutic drugs were summarized.

Genetic progress of childhood absence epilepsy / 上海交通大学学报（医学版）

Childhood absence epilepsy (CAE) is an important kind of epileptic syndrome of genetic generalized epilepsies (GGEs) with prevalence of 5.8/100 000-7.1/100 000.The genetic mechanism of CAE is always the hotspot of research.Susceptibility genes including calcium channel and γ-aminobutyric acid receptor as well as copy number variations (CNVs) have been found.However,those mechanisms cannot explain all the situations since the genetic content of CAE is rather complicated.Nowadays,with new susceptibility genes and genetic mechanisms coming to light,researchers are supposed to study this problem from the point of associated epileptic syndromes.In this review,the genetic features,probable mechanisms of CAE and therapeutic drugs were summarized.

The short-term prognostic evaluation in first-drug therapy outcome in children with absence epilepsy / 中华实用儿科临床杂志

Objective To observe the initial therapy outcomes of Valproic acid for childhood absence epilepsy (CAE),and to assess its therapeutic reaction and short-term prognosis,and to investigate the risk factors for initial therapy failure.Methods From January 2010 to December 2015,absence seizures as key words were used to search CAE in the video-electroencephalogram(VEEG) database of Children's Hospital Affiliated to Nanjing Medical University.Sixty-seven children fulfilled the CAE diagnosis criteria of International League Against Epilepsy in 1989.These patients were separated into 2 groups based on the therapy outcome after 6 months,including seizure control failure group and seizure control group.The patients' clinical characteristics and VEEG characteristics were reviewed.The gender,age of seizure onset,a family history of epilepsy or febrile seizures (FS),consistent with 2005 Panayiotopoulos diagnostic criteria,and VEEG findings were analyzed to evaluate the predictive ability of independent variables and the relationship between these features and treatment outcomes by using a stepwise multivariate Logistic regression model.Results The age at seizure onset was (5.89 ± 2.91) years old,and follow up duration was 6 months.Approximately 23 cases (34.3％) of CAE patients had poor response.No statistical correlation was made for gender,age at onset,the occurrence of generalized tonic clonic seizures,and family history of FS or epilepsy between 2 groups (all P ＞0.05).Compared with seizure control group,patients of the seizure control failure group had significantly higher rates of focal epileptic discharge (87.0％ vs.6.8％),higher rates of intermittent photic stimulation (IPS) induced seizures (52.2％ vs.6.8 ％),fewer rates of occipital intermittent delta activity (8.7 ％ vs.77.3 ％),and fewer rates of patients met the new diagnostic criteria proposed by Panayiotopoulos in 2005 (8.7％ vs.88.6％) (all P ＜ 0.001).The presence of occipital intermittent rhythmic delta activity during wake stage and the interictal focal epileptiform discharges on VEEG during sleep stage were significantly associated with the therapy outcomes in a multivariable Logistic regression analysis (OR =133.714,P ＜ 0.05;OR =0.068,P ＜ 0.05).Conclusions The presence of focal epileptiform discharges,and a typical absence induced by IPS are important factors for first-drug treatment failures with CAE,and conversely the occipital intermittent rhythmic delta activities have a good efficacy.There is no statistical correlation between clinical characteristics and treatment outcomes.

Lamotrigine for absence seizures in children and adolescents：a systematic review / 药学实践杂志

Objective To assess the efficacy and safety of lamotrigine for absence seizures in children and adolescents . Methods Databases of PubMed ,the Cochrane Library ,EMbase ,CENTRAL ,VIP ,WanFang ,CBM and CNKI were electron-ically searched till August ,2014 for clinical trials on lamotrigine for absence seizures in children and adolescents .All literature were screened by two reviewers independently according to the inclusion and exclusion criteria .The data was extracted ,and the methodological quality was assessed .Then ,meta-analysis was performed using RevMan 5 .2 .Results Seven trials were in-cluded involving a total of 721 patients .The results of methodological qualities were two studies rated as A-class ,three studies rated as B-class and two studies rated as C-class .Meta-analysis results showed that the efficacy of lamotrigine monotherapy for absence seizure in children and adolescents was better than placebo ,but efficacy of lamotrigine was lower than valproic acid and ethosuximide .The adverse reaction rates of lamotrigine were with no significant difference compared with valproic acid and et-hosuximide .Conclusion Lamotrigine monotherapy was effective for absence seizures in children and adolescents and was well tolerated .Lamotrigine was a good choice for patients that are intolerable to valproic acid or ethosuximide .

Study on EEG of childhood absence epilepsy / 中国基层医药

Objective To investigate the characteristics of electroencephalograms ( EEGs ) of patients with childhood absence epilepsy ( CAE ) .Methods EEG of 46 patients with CAE were analyzed .Results Of 46 patients,there were 44 cases (95.6%) with guided bilateral symmetry 3Hz spike-and-wave.16 cases were character-ized by multiple spike-and-wave on the 3Hz spike and slow wave;and the centrotemporal spikes was found in 1 case. Additionally,the 3Hzδactivity in occipital region has been traced in 34 cases of these 46 patients.Conclusion In general,the EEGs of CAE patients have typical characteristics ,and few of them showed atypical manifestation ,which must be verified by clinical attention .

Mutation Screening of the gamma-Aminobutyric Acid Type-A Receptor Subunit gamma2 Gene in Korean Patients with Childhood Absence Epilepsy

BACKGROUND AND PURPOSE: Since the gamma-aminobutyric acid type-A receptor subunit gamma2 gene (GABRG2) mutation was discovered in an Australian family with childhood absence epilepsy (CAE) and febrile convulsions, a few screening studies for the GABRG2 mutation have been conducted in sporadic individuals with CAE from other ethnic groups. The aim of this study was to determine whether or not the previously reported genetic mutations and single-nucleotide polymorphisms (SNPs) of GABRG2 can be reproduced in sporadic Korean individuals with CAE, compared to healthy Korean individuals. METHODS: Thirty-five children with CAE in Chonnam National University Hospital and healthy controls (n=207) were enrolled, and the medical records of patients with CAE were reviewed. CAE was diagnosed according to the Classification and Terminology of the International League Against Epilepsy. All nine exons of GABRG2 were directly sequenced. In addition, the two SNPs found in our CAE patients were analyzed: C315T in exon 3 (E3) and C588T in exon 5 (E5). The frequencies of the two SNPs in the CAE patients were compared with data from healthy controls (for E3 and E5) and from previously reported Korean population data (only for E3). RESULTS: No mutation of GABRG2 was found in our CAE patients. In addition, the allele and genotype frequencies of the two polymorphisms did not differ significantly between CAE patients, healthy controls, and the Korean general population (p>0.05). CONCLUSIONS: Our study of sporadic Korean individuals with CAE found no evidence that GABRG2 contributes to the genetic basis of CAE.

Enfoque electroclínico de las epilepsias generalizadas idiopáticas con ausencias: [revisión] / Electrolytic approach of idiopathic generalized epilepsies with absences: [review]

La primera descripción de las crisis de ausencias data de 1705. Sin embargo, aún persiste el desconocimiento y la confusión en relación con algunos aspectos conceptuales, de clasificación, terminológicos, diagnósticos, pronósticos y de tratamiento de las diferentes formas de epilepsias con ausencias. El objetivo fundamental de esta publicación es tomar en consideración las denominadas epilepsias generalizadas idiopáticas con ausencias, en los aspectos clínicos y electroencefalográficos. Se realizó una revisión y actualización del tema.

The first description of absence seizures dates back to 1705. However, the lack of knowledge and confusion still persist as regards some aspects of concept, classification, terminology, diagnosis, prognosis and treatment of the different forms of epilepsies with absences. The fundamental purpose of this publication was to take into consideration the so-called idiopathic generalized epilepsies with absences in the clinical and electroencephalographic aspects. The topic was reviewed and updated.

Concomitant Absence and Occipital Lobe Epilepsy in an Adolescent

The incidence of absence and occipital lobe epilepsy appearing in the same young individual is quite rare. A fourteen year-old girl has had two types of recurrent seizures: 1)simple partial seizure with secondary generalization probably originating in the left occipital lobe, and 2)absence seizure. Electroencephalogram demonstrated frequent spikes on the left occipital region with or without bilateral synchronization and generalized 3 Hz spike and wave complexes during hyperventilation procedure and photic stimulation.

A Case of a Coincidence of Rolandic and Childhood Absence Epilepsy / 대한소아신경학회지

Rolandic epilepsy(or benign epilepsy with centrotemporal spikes) and childhood absence epilepsy are idiopathic epilepsies and are the most common forms of age-related epilepsies, occurring in previously neurologically normal children. Benign epilepsy with centrotemporal spikes is the most common partial childhood epilepsy, beginning between 2 and 13 years of age and characterized by typical EEG focal discharges and a self- limited course with recovery in or before puberty. Childhood absence epilepsy is one of generalized epilepsies with bilateral synchronous and symmetrical spike-wave paroxysms of 3 Hz and it has a good prognosis under a correct antiepilepsy treatment. These two epilepsies share some common features : similar age at onset, overall good prognosis and marked hereditary predisposition. A coincidence of these two epilepsies in a patient is very rare. We experienced a case of a coincidence of rolandic and childhood absence epilepsy in a 6 year-old female. The presence of an absence focus in rolandic epilepy, however, makes the coincidence of these entirely distinct phenomena, even if very rare, not excluded. We present the case with a review of related literature.

Cognitive Characteristics in Children with Absence Epilepsy / 实用儿科临床杂志

0.05).The scales of subtests including arithmetic,digit span,picture completion,block design and coding of children in CAE group were significantly lower than those of control group(Pa

Psychomotor Variant in a Case of Juvenile Absence Epilepsy: An Evidence of Misnomer by Gibbs / 대한간질학회지

The psychomotor variant is a rare EEG pattern as a rhythmical activity at about 6 Hz that may occur in brief or longer runs, independently in the temporal areas during drowsy mental state. It was originally named by Gibbs and Gibbs because of its existence during the ictal or interictal period in patients with psychomotor seizures. We report a 14-year-old girl with juvenile absence epilepsy who showed the long runs of psychomotor variant followed by generalized ictal discharges.

Concomitance of Childhood Absence Epilepsy and Benign Rolandic Spikes / 대한간질학회지

Childhood absence epilepsy (CAE) and benign epilepsy of childhood with centro-temporal spikes (BECT) are common forms of idiopathic epilepsy of childhood onset and share many features such as the marked age dependence of onset. The occurrence of generalized 3 Hz spike and waves in BECT or rolandic spikes in CAE has rarely been reported. We report 2 cases of concomitance of CAE and benign rolandic spikes. All of the two patients were female and had clinically absence seizure only. On EEG the two patients simultaneously showed centro-temporal spikes as well as ictal onset of absence seizure consisting of generalized 3 Hz spike and waves. All of the two patients have become seizure-free with valporic acid. It is rare but not impossible that (Rolandic spikes can concur with CAE rather than as a continuum between CAE and BECT), because all of the two patients have not shown BECT so far.