Summary:Purpose: To examine whether magnetoencephalography (MEG) can be used to determine patterns of brain activity underlying widespread paroxysms of epilepsy patients, thereby extending the applicability of MEG to a larger population of epilepsy patients.Methods: We studied two children with symptomatic localization-related epilepsy. Case 1 had widespread spikes in EEG with an operation scar from a resection of a brain tumor; Case 2 had hemispheric slow-wave activity in EEG with sensory auras. MEG was collected with a 204-channel helmet-shaped sensor array. Dynamic statistical parametric maps (dSPMs) were constructed to estimate the cortical distribution of interictal discharges for these patients. Equivalent current dipoles (ECDs) also were calculated for comparison with the results of dSPM.Results: In case 1 with widespread spikes, dSPM presented the major activity at the vicinity of the operation scar in the left frontal lobe at the peak of the spikes, and some activities were detected in the left temporal lobe just before the peak in some spikes. In case 2 with hemispheric slow waves, the most active area was located in the left parietal lobe, and additional activity was seen at the ipsilateral temporal and frontal lobes in dSPM. The source estimates correlated well with the ictal manifestation and interictal single-photon emission computed tomography (SPECT) findings for this patient. In comparison with the results of ECDs, ECDs could not express a prior activity at the left temporal lobe in case 1 and did not model well the MEG data in case 2.Conclusions: We suggest that by means of dSPM, MEG is useful for presurgical evaluation of patients, not only with localized epileptiform activity, but also with widespread spikes or slow waves, because it requires no selections of channels and no time-point selection. Key Words: MEG-Dynamic statistical parametric mapping-Generalized spike-Slow waveEpilepsy.The appropriate diagnosis of the epileptic syndrome based on the international classification of the epilepsies and epileptic syndromes is the most important factor in treatment decisions by the epileptologist (1). Currently, the diagnosis depends mainly on symptomatic and electrophysiologic findings. In this process, the analysis of interictal discharges (IIDs) and ictal discharges (IDs) in the EEG has played one of the most valuable parts. Magnetoencephalography (MEG) is complementary to EEG; the magnetic fields seen with MEG are selectively sensitive to tangentially oriented source current and are less influenced by the differences in conductivities in the head than are the electrical scalp potentials.

We report on a family in which a male infant had the asplenia syndrome, a younger brother had the polysplenia syndrome, and their father had situs inversus totalis. The occurrence of the asplenia and the polysplenia syndromes in a sibship of the present family and in two other previously reported sibships indicates that the two syndromes are causally and pathogenetically related to each other. If it is assumed that the father had an incomplete form of the polysplenia complex, then the condition in this family either is an autosomal dominant trait or is multifactorially determined.

We administered perampanel (PER) to a bedridden 13-year-old male patient with dentatorubral-pallidoluysian atrophy (DRPLA). The DRPLA diagnosis was based on the presence of a CAG trinucleotide repeat in the ATN1 gene. The patient experienced continuous myoclonic seizures and weekly generalized tonic–clonic seizures (GTCs). PER stopped the patient's myoclonic seizures and reduced the GTCs to fragmented clonic seizures. The patient recovered his intellectual abilities and began to walk again with assistance. We suggest that PER be considered as one of the key drugs used to treat patients with DRPLA.

The amount of slow wave sleep (SWS) declines with increasing age 1,2 and it is well known that gender difference on sleep parameters have been noted in the middle aged and elderly. 3,4 The purpose of this study is to investigate gender effects on slow wave activity in middle aged and elderly subjects by spectral analysis. SUBJECTS AND METHODSEight healthy male subjects (61.50 ± 4.66 years) and eight female subjects (62.38 ± 6.65 years) participated in this study. None of the participants had had a significant medical history and during the study were free of medication. The subjects were asked to avoid sleep during the day and sleep electroencephalograms were recorded for three consecutive nights at their homes using an ambulatory monitoring system to maintain their daily sleep conditions. Third-night EEG were visually scored by a 20-s epoch according to the criteria of Rechtschaffen and Kales. The EEG (C3-A2) was digitized at a sampling rate of 125 Hz (the sampling period was 8 ms). Power spectra were calculated by FFT over 1024 data points with a cosine bell window. The spectral power through nocturnal sleep and the mean spectral power per 30 s were obtained for two frequency bands (0.5-2 Hz and 2-4 Hz). For statistical analysis, the spectral power was normalized by a logarithmic transformation and the Mann-Whitney U test was used to compare spectral power between genders. Figure 1 shows two hypnograms for both male and female subjects. The sleep continuity of a male subject aged 61 years was maintained, while a female subject aged 72 years showed long awakenings in the latter part of sleep. The length of SWS was shown to be longer in the female than the male. There were no significant gender differences in visually scored EEG parameters: time in bed, sleep period time, total sleep time, sleep efficiency, number of awakenings, sleep latency, REM latency and percentages of stage W, 1, 2, REM. However, females showed a higher percentage of stage 3 + 4 as compared with males (mean % ± SD, Psychiatry and Clinical Neurosciences (1999) RESULTS AbstractSleep EEG of eight healthy males and eight females aged 54-72 years were recorded at their homes. The electroencephalograms were visually scored and analyzed by spectral analysis using the FFT method. There were no significant differences in sleep parameters except for a higher percentage of stage 3 + 4 in females. The spectral power of the delta band EEG was classified into two frequencies: 0.5-2 Hz and 2-4 Hz. The total amount of the delta band spectral power through the night was significantly larger in females. Periodic fluctuation of delta band power was observed in females along with non-rapid eye movement-rapid eye movement cycles.

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