Generalized 3-Hz spike-and-wave complexes emanating from focal epileptic activity in pediatric patients

Yosuke Kakisaka, Andreas V. Alexopoulos, Ajay Gupta, Zhong I. Wang, John C. Mosher, Masaki Iwasaki, Richard C. Burgess

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)103-106
Number of pages4
JournalEpilepsy and Behavior
Issue number1
Publication statusPublished - 2011 Jan


  • 3-Hz spike-and-wave complex
  • Focal epileptic activity
  • Magnetoencephalography


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