TY - JOUR
T1 - Generalized 3-Hz spike-and-wave complexes emanating from focal epileptic activity in pediatric patients
AU - Kakisaka, Yosuke
AU - Alexopoulos, Andreas V.
AU - Gupta, Ajay
AU - Wang, Zhong I.
AU - Mosher, John C.
AU - Iwasaki, Masaki
AU - Burgess, Richard C.
PY - 2011/1
Y1 - 2011/1
N2 - We describe two pediatric patients with an uncommon electrophysiological seizure propagation pattern. Both had dialeptic seizures as the main or only symptom. Case 1 had a small mass in the left medial temporal structures; case 2 had no lesion on magnetic resonance imaging. In both, the electroencephalogram showed not only left temporal spikes, but also bilaterally synchronous 3-Hz spike-and-wave complexes (SWCs) from onset and unusual secondarily generalized 3-Hz SWC patterns arising from the left temporal region. Case 1 was seizure free following resection of the mass; focal or generalized epileptiform electroencephalographic abnormalities were no longer present. In case 2, magnetoencephalography localized the spikes to the left superior and midtemporal gyrus, which ictal single-photon-emission computed tomography suggested was the origin of onset. These cases illustrate the close relationship between the focal epileptic area and 3-Hz SWCs and suggest that the focal area can trigger 3-Hz SWCs. The therapeutic strategy may need to be altered in such patients.
AB - We describe two pediatric patients with an uncommon electrophysiological seizure propagation pattern. Both had dialeptic seizures as the main or only symptom. Case 1 had a small mass in the left medial temporal structures; case 2 had no lesion on magnetic resonance imaging. In both, the electroencephalogram showed not only left temporal spikes, but also bilaterally synchronous 3-Hz spike-and-wave complexes (SWCs) from onset and unusual secondarily generalized 3-Hz SWC patterns arising from the left temporal region. Case 1 was seizure free following resection of the mass; focal or generalized epileptiform electroencephalographic abnormalities were no longer present. In case 2, magnetoencephalography localized the spikes to the left superior and midtemporal gyrus, which ictal single-photon-emission computed tomography suggested was the origin of onset. These cases illustrate the close relationship between the focal epileptic area and 3-Hz SWCs and suggest that the focal area can trigger 3-Hz SWCs. The therapeutic strategy may need to be altered in such patients.
KW - 3-Hz spike-and-wave complex
KW - Focal epileptic activity
KW - Magnetoencephalography
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U2 - 10.1016/j.yebeh.2010.10.025
DO - 10.1016/j.yebeh.2010.10.025
M3 - Article
C2 - 21131239
AN - SCOPUS:78651240435
SN - 1525-5050
VL - 20
SP - 103
EP - 106
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
IS - 1
ER -