Generalized, Bilaterally Synchronous Bursts of Slow Waves in the EEG

Schaul, Neil; Lueders, Hans; Sachdev, Kuldip K.

doi:10.1001/archneur.1981.00510110050006

Cited by 37 publications

(14 citation statements)

References 9 publications

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“…First, slow-wave activity may be used to aid estimates of the location of epileptogenic zones (Gloor et al, 1977;Schaul, 1981Schaul, , 1990. In a previous study, our group (Ishibashi et al, 2002) examined the significance of focal, slow-wave and interictal spike activity detected using MEG in 29 patients who had mesial temporal lobe epilepsy (MTLE) not associated with structural brain lesions.…”

Section: Discussionmentioning

confidence: 99%

Toward the Substitution of Invasive Electroencephalography in Epilepsy Surgery

Papanicolaou¹,

Pataraia²,

Billingsley-Marshall³

et al. 2005

Journal of Clinical Neurophysiology

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The authors compared the localization accuracy of interictal magnetoencephalography (MEG) with ictal and interictal invasive video electroencephalography (VEEG) in identifying the epileptogenic zone in epilepsy surgery candidates. Forty-one patients, 29 with temporal lobe epilepsy (TLE) and 12 with extratemporal lobe epilepsy (ETLE), participated. Only patients with interictal changes during the MEG recordings were included. A comparison of the accuracy of invasive VEEG and MEG seizure zone identification was based on the degree of overlap between the location of the actual surgical resection and the zone identified by each method, and the success of surgery in reducing seizure activity. No statistical differences were observed between the accuracy of invasive VEEG and MEG in determining the location of the seizure zone across TLE and ETLE cases. Invasive VEEG and MEG localization judgments were correct in 54% and 56% of the cases, respectively. Separate group analyses suggested that MEG may be less beneficial relative to invasive VEEG in ETLE than TLE cases. MEG is of statistically equivalent accuracy to invasive VEEG, despite the fact that its use has not reached optimal conditions. The authors predict the replacement of the more invasive procedure with MEG in the near future for TLE cases, subsequent to the optimization of the conditions under which preoperative MEG is performed.

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Section: Discussionmentioning

confidence: 99%

Toward the Substitution of Invasive Electroencephalography in Epilepsy Surgery

Papanicolaou¹,

Pataraia²,

Billingsley-Marshall³

et al. 2005

Journal of Clinical Neurophysiology

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“…Altered carbohydrate metabolism was found in some patients with familial intermittent ataxia, and it was suggested that a partial defect in the pyruvate dehydrogenase enzyme complex leading to accumulation of pyruvate and lactate may be the causative metabolic abnormality (32). The EEG abnormalities described above can indeed be seen with metabolic derangements (34). In several cases with familial APRA, cerebellar atrophy was noted (18,19,32).…”

Section: Discussionmentioning

confidence: 89%

“…has not significantly altered the EEG that continued to show generalized intermittent slowing with or without the sharp wave activity (cases 1, 3, and 4) (19). Generalized bisynchronous intermittent rhythmic slow activity in the delta frequency range, often composed of runs of sinusoidal or sawtoothed waves maximal in the frontal regions, is of unknown specific pathogenesis and can occur in diverse disease states affecting cortical or subcortical levels in response to systemic toxic or metabolic disturbances as well as diffuse or focal cerebral diseases (34). The basic cause of periodic ataxia is unknown.…”

Section: Discussionmentioning

confidence: 99%

The electroencephalogram in acetazolamide‐responsive periodic ataxia

et al. 1996

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Acetazolamide-responsive periodic ataxia (ARPA) is a rare movement disorder, characterized by recurrent episodes of vertigo, cerebellar ataxia, and nystagmus, which has recently been characterized genetically. The pathophysiology is unknown, but it is probably not epileptic. By definition, acetazolamide produces an impressive symptomatic relief. Because of the paroxysmal nature of the disorder, EEG tracings were often obtained. We report four new cases (two familial and two sporadic) with typical ARPA (none of whom had metabolic abnormalities or continuous electrical muscle activity) and review the EEG findings associated with this disorder. EEG findings were reported in 18 kindreds and nine sporadic cases (including ours). EEG was described in 54 of the 140 affected cases and was abnormal in 52% (28/54). Most commonly seen was intermittent generalized slow activity, observed in 35% (19/54), frequently intermingled with spikes (10 cases). Other abnormalities included nonspecific mild generalized or focal slowing in seven (13%) and focal epileptic activity in two (4%) patients. The paroxysmal EEG activity frequently seen in ARPA should not establish a diagnosis of epilepsy. Although not specific, it may suggest the correct diagnosis and indicate treatment with acetazolamide.

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“…TWs (River and Zelig, 1993) and generalized periodic sharp waves resembling Creutzfeld-Jacob Disease have been described (Nieman, 1959; Lansing and Trunell, 1963; Hermann and Quarton, 1964). Rarely, frontal intermittent rhythmic delta activity (FIRDA) occurs (Schaul et al, 1981). In infants with congenital hypothyroidism, there is a delay in development of the EEG phenomena of sleep, particularly sleep spindles (Schultz et al, 1968).…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, while the increase in theta and delta activity during mild hypoglycemia with serum glucose levels between 50 and 60 mg/dl reaches its topographic maximum in the frontal region, the maximum of slow frequencies during more profound hypoglycemia is found in the centro-temporal and parieto-occipital regions (Tribl et al, 1996). Occasionally, a FIRDA pattern may be observed in hypoglycemic patients (Schaul et al, 1981). Epileptiform discharges have been described during hypoglycemia particularly in patients with diabetes mellitus (Bjorgaas et al, 1998), and accentuation of focal temporal spikes or sharp waves was seen at serum glucose levels below 45 mg/dl in patients with a known history of complex-partial seizures (Sperling, 1984).…”

Section: Introductionmentioning

confidence: 99%

Electroencephalography of Encephalopathy in Patients With Endocrine and Metabolic Disorders

Faigle

Sutter

Kaplan

2013

Journal of Clinical Neurophysiology

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Patients with acute alteration in mental status from encephalopathy due to underlying metabolic-toxic or endocrine abnormalities are frequently seen in the acute hospital setting. A rapid diagnosis and correction of the underlying cause is essential as a prolonged state of encephalopathy portends a poor outcome. Correct diagnosis and management remain challenging because several encephalopathies may present similarly, and further laboratory, imaging or other testing may not always reveal the underlying cause. Electroencephalography (EEG) provides rapid additional information on the encephalopathic patient. It may help establish the diagnosis, and is indispensable for identifying non-convulsive status epilepticus – an important possible complication in this context. The EEG may assist the clinician in gauging the severity of brain dysfunction, and may aid in predicting outcome. This review summarizes the current knowledge on EEG findings in selected metabolic and endocrine causes of encephalopathy, and highlights distinct EEG features associated with particular etiologies.

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Generalized, Bilaterally Synchronous Bursts of Slow Waves in the EEG

Cited by 37 publications

References 9 publications

Toward the Substitution of Invasive Electroencephalography in Epilepsy Surgery

Toward the Substitution of Invasive Electroencephalography in Epilepsy Surgery

The electroencephalogram in acetazolamide‐responsive periodic ataxia

Electroencephalography of Encephalopathy in Patients With Endocrine and Metabolic Disorders

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