Longitudinal Study of Epileptiform EEG Patterns in Normal Children

Abstract

EEG were recorded in 3,726 children, from 6 to 13 years of age who were neurologically normal and had no history of epileptic seizures. The records were taken during wakefulness, at rest, and during hyperventilation. In 131 cases (3.54%) epileptiform patterns were found. They consisted of 3 count/sec spike and slow waves discharges (4 cases), multiple spike and slow wave complexes (37 cases), midtemporal spikes (50 cases), rolandic or parietal spikes (27 cases), occipital spikes (2 cases), and multifocal spikes (11 cases). Half of the subjects with EEG abnormalities had behavior problems and/or slight psychomotor ability disturbances. Follow-up studies over an 8 to 9 year period were performed. These demonstrated the spontaneous disappearance of the EEG abnormalities, usually within school age or, at the latest, during adolesence. Only seven individuals developed epileptic seizures of the primary generalized type which responded well to anticonvulsant drug treatment. From this study we can deduce that the epileptiform EEG patterns that often are found in children during school age have no clinical relationship to epilepsy in the great majority of cases. The relationship with epilepsy exists probably on a genetic level for the generalized discharges. The spike foci are non-epileptic in nature in all probability, especially if they emerge from a fairly normal background activity and their duration is very similar to that of the constituents of the background activity, as found in the majority of these subjects. On the contrary, it is probable that these alterations express difficulties in affective or motor adaptation during childhood.

Benign Idiopathic Partial Epilepsy and Brain Lesion

“…Regarding pathogenesis, these cases can be interpreted in two ways: First, the combination of lesional symptoms and the characteristic EEG pattern is coincidental, leading to additive effects on the seizure threshold in the sense of a multifactorial pathogenesis, or, second, the focal EEG changes represent a phenocopy of the genetic pattern caused by an acquired or congenital brain lesion. The first hypothesis can be verified, proving the genetic origin of the EEG pattern in the patient only by demonstrating a typical sharp-wave focus Accepted September 18,1998. Address correspondence and reprint requests to Dr. U. Stephani at Neuropediatric Department, University of Kiel, Schwanenweg 20, D 24105 Kiel, Germany. in this sibship.…”

A Review of the Not So Benign- Benign Childhood Epilepsy with Centrotemporal Spikes

“…CTS are not solely associated with BECTS. CTS may be found in 2-3% of normal school-age children, of whom less than 10% develop rolandic epilepsy [16,17]. Age-dependent CTS frequently occur in a variety of organic brain diseases with or without seizures, such as cerebral tumours, Rett syndrome, fragile X syndrome and focal cortical dysplasia.…”

Clinical Significance of Epileptiform Activity in Electroencephalogram

“…Чаще эпилептиформная активность обнаружива-ется в популяции детей без эпилептических приступов. Согласно нескольким большим популяционным ис-следованиям ЭЭГ у здоровых детей в возрасте 6-13 лет, на ЭЭГ выявлены эпилептиформные изменения (реги-ональные и генерализованные) у 1,85-5,0 % детей [19,32,66]. Лишь у 5,3-8,0 % детей, у которых была обна-ружена эпилептиформная активность на ЭЭГ, в даль-нейшем развились эпилептические приступы [18,32].…”

“…Согласно нескольким большим популяционным ис-следованиям ЭЭГ у здоровых детей в возрасте 6-13 лет, на ЭЭГ выявлены эпилептиформные изменения (реги-ональные и генерализованные) у 1,85-5,0 % детей [19,32,66]. Лишь у 5,3-8,0 % детей, у которых была обна-ружена эпилептиформная активность на ЭЭГ, в даль-нейшем развились эпилептические приступы [18,32]. В одном из последних исследований ЭЭГ у 393 здоро-вых детей в возрасте 12-60 мес было показано, что рас-пространенность эпилептиформной активности у детей в возрасте до 5 лет составила 0,76 %, что значительно ниже, чем у детей старшего возраста [23].…”