Paroxysmal beta activity in the pediatric electroencephalogram

Nealis, J; Duffy, Frank H.

doi:10.1002/ana.410040204

Cited by 41 publications

(13 citation statements)

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“…For example, prior studies, in mostly adult patients where sleep recordings were not uniformly performed, reported scalp PFA in 0.2% to 3.4% of patients with a slightly higher percentage in pediatric patients (Gibbs et al 1943; Nealis and Duffy 1978; Rodin et al 1976). Our results found a much higher percentage of patients with PFA, especially in children under age 3 years with seizures, and these pathologic oscillations were not found in individuals with non-epileptic events.…”

Section: Discussionmentioning

confidence: 99%

“…Enthusiasm in using scalp PFA in the diagnostic assessment of patients with seizures has been low because they are reported to occur in less than 4% of EEG records (Halasz et al 2004; Nealis and Duffy 1978). However, there has been resurged interest in fast and very-fast EEG oscillations as potential surrogate markers in identifying epileptic networks in humans and animal models of epilepsy (Bragin et al 1999a; Bragin et al 1999b; Bragin et al 2002a; Bragin et al 2002b; Jirsch et al 2006; Rampp and Stefan 2006; Traub 2003; Traub et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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Paroxysmal fast activity: An interictal scalp EEG marker of epileptogenesis in children

Koh

Sankar

et al. 2008

Epilepsy Research

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Purpose High frequency oscillations (>100 Hz) have been proposed as localized markers of epileptic networks, but require intracranial electroencephographic (EEG) recordings. This study explored if β- and γ- frequency paroxysmal fast activity (PFA), recorded interictally during non-REM sleep, could be used as a scalp EEG marker of epileptogenesis in children. Methods The presence and scalp location of PFA was visually identified in 681 patients with overnight video-EEG (age 0 to 18 years), and compared with ictal onset sites. The clinical features of patients with PFA were compared with patients without PFA along with evidence of PFA evolution in 35 patients who had multiple video-EEG records. Results PFA was present in 16% of all patients and in 28% of those with seizures. PFA was more frequently observed in EEGs from patients 3 years of age or younger (>40%), and children with infantile spasms (85%). When present, PFA predicted if the patient had epilepsy with 97% accuracy, and was not found in individuals with non-epileptic events. PFA localized with EEG-ictal onset sites with 91% sensitivity and 82% accuracy. Ictal scalp EEG events began with β- and γ-frequencies in 80% of patients with PFA, and they had increased seizure frequencies compared with non-PFA cases. In patients with multiple video-EEG studies, PFA showed progression over increased numbers of electrodes in 74%, improvement in 15%, and remained unchanged in 12% and correlated with seizure evolution. PFA was not associated with other seizure types, anatomic location, type of antiepileptic drug, etiology, or histopathology. Conclusions While relatively infrequent, interictal PFA was specific in identifying younger children with epilepsy, co-localized with the ictal onset sites on scalp video-EEG, and progressed and correlated with seizure severity. We propose that PFA is a scalp EEG marker of epileptic networks with the advantage of being recorded non-invasively during interictal non-REM sleep.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paroxysmal fast activity: An interictal scalp EEG marker of epileptogenesis in children

Koh

Sankar

et al. 2008

Epilepsy Research

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“…Moreover, it is difficult to distinguish between normal and abnormal HFOs 18,19 since both ripples and fast ripples are present even in normal human brain tissue 20 . Early studies reported HFOs in scalp EEG in only a small (0.2 -3.4%) portion of patients with epilepsy [21][22][23] . However, recent studies have shown that HFOs can be detected noninvasively with scalp EEG.…”

Section: Introductionmentioning

confidence: 99%

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Papadelis

Tamilia

Stufflebeam

et al. 2016

JoVE

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Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings. Here, we present a methodology for the recording, detection, and localization of interictal HFOs from pediatric patients with refractory epilepsy. We report representative data of HFOs detected noninvasively from interictal scalp EEG and MEG from two children undergoing surgery.The underlying generators of HFOs were localized by solving the inverse problem and their localization was compared to the Seizure Onset Zone (SOZ) as this was defined by the epileptologists. For both patients, Interictal Epileptogenic Discharges (IEDs) and HFOs were localized with source imaging at concordant locations. For one patient, intracranial EEG (iEEG) data were also available. For this patient, we found that the HFOs localization was concordant between noninvasive and invasive methods. The comparison of iEEG with the results from scalp recordings served to validate these findings. To our best knowledge, this is the first study that presents the source localization of scalp HFOs from simultaneous EEG and MEG recordings comparing the results with invasive recordings. These findings suggest that HFOs can be reliably detected and localized noninvasively with scalp EEG and MEG. We conclude that the noninvasive localization of interictal HFOs could significantly improve the presurgical evaluation for pediatric patients with epilepsy.

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“…Early studies reported fast oscillations in scalp EEG of only a small percentage of epileptic patients (Rodin et al, 1976;Nealis and Duffy, 1978). In the past few years there have been several reports of fast oscillations in scalp EEG (Kobayashi et al, 2004(Kobayashi et al, , 2010Inoue et al, 2008;Wu et al, 2008;Yamazaki et al, 2009;Andrade-Valença et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Automatic detection of fast oscillations (40–200Hz) in scalp EEG recordings

Ellenrieder

Andrade-Valença

Dubeau

et al. 2012

Clinical Neurophysiology

101

111

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Objective-We aim to automatically detect fast oscillations (40-200 Hz) related to epilepsy on scalp EEG recordings.Methods-The detector first finds localized increments of the signal power in narrow frequency bands. A simple classification based on two features, a narrowband to wideband signal amplitude ratio and an absolute narrowband signal amplitude, then allows for an important reduction in the number of false positives.Results-When compared to an expert, the performance in 15 focal epilepsy patients resulted in 3.6 false positives per minute at 95% sensitivity, with at least 40% of the detected events being true positives. In most of the patients the channels showing the highest number of events according to the expert and the automatic detector were the same.Conclusions-A high sensitivity is achieved with the proposed automatic detector, but results should be reviewed by an expert to remove false positives.Significance-The time required to mark fast oscillations on scalp EEG recordings is drastically reduced with the use of the proposed detector. Thus, the automatic detector is a useful tool in studies aiming to create a better understanding of the fast oscillations visible on the scalp.

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Paroxysmal beta activity in the pediatric electroencephalogram

Cited by 41 publications

References 10 publications

Paroxysmal fast activity: An interictal scalp EEG marker of epileptogenesis in children

Paroxysmal fast activity: An interictal scalp EEG marker of epileptogenesis in children

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Automatic detection of fast oscillations (40–200Hz) in scalp EEG recordings

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