Epileptic syndromes: differential treatment in infants, children, and adolescents.

This paper proposes therapeutic guidelines for the management of some epileptic syndromes in infants, children, and adolescents, based on available medical literature and clinical practice in the French Community of Belgium. The guidelines address both epileptic encephalopathies (West syndrome, Lennox-Gastaut syndrome, and Dravet syndrome) and idiopathic epilepsies (typical absence seizures, epilepsy with centro-temporal spikes and juvenile myoclonic epilepsy).

Spike detection algorithm automatically adapted to individual patients applied to spike-and-wave percentage quantification.

OBJECTIVE: To report an innovative spike detection algorithm that tailors its detection to the patient. Interictal epileptiform activity quantification was accomplished in the setting of epileptic syndromes with continuous spike and waves during slow sleep, which is a time-consuming task for the EEG analysis. METHODS: The algorithm works in three steps. Firstly, a first spike detection is made with generic parameters. Secondly, the detected spikes are used to tailor the detection algorithm to the patient; and thirdly, the resulting patient-specific detection algorithm is used to analyze individual patient with high-quality detection. Therefore, the algorithm produces a patient-specific template -hence exhibiting improved performance metrics, without the need of a priori knowledge from the experts. RESULTS: The system was first evaluated for EEG of three patients, against the scoring of three EEG experts, demonstrating similar performance. Later, it was evaluated against the spike and wave percentage evaluation of another expert for 17 additional records. The difference between the two evaluations was 4.4% on average, which is almost the same as the interexpert difference (4.7%). CONCLUSIONS: We designed a fully automated and efficient spike detection algorithm, which is liable to trim down the specialist's diagnostic time.