Small sharp spikes as EEG markers of mesiotemporal lobe epilepsy.

Objective: Mesial temporal lobe epilepsy (mTLE) is the most common type of focal epilepsy, but often lacks scalp EEG correlates. We ask if hippocampal epileptiform discharges that are characteristic of mTLE are associated with small sharp spikes (SSS) recorded on scalp EEG. SSS are considered benign waveforms, so are not currently used as markers of epilepsy.

Prevalence of benign epileptiform variants during initial EEG examination in French military aircrew.

Introduction: In France, a systematic EEG is performed during initial examination in military aircrew applicants, which may provide an estimation of the prevalence of benign epileptiform variants in healthy adults.

Methods: We analyzed standard EEG (21 scalp electrodes, 20minutes, 400Hz sampling rate) of military aircrew applicants examined in the French Main Aeromedical Center in 2016. EEGs were analyzed using both bipolar and referential montages.

Positive interictal epileptiform discharges in adults: A case series of a rare phenomenon.

Objective: Positive interictal epileptiform discharges (IEDs) are rarely recorded from surface EEG, due to the orientation of the cortex and its neurons. Their frequency and significance in adults is unknown, and has only been studied as a phenomenon of the neonatal period and childhood. We aimed to evaluate the frequency and characteristics of positive epileptiform discharges in a large cohort of patients.

Early-Onset Shapiro Syndrome Variant Treated with Pizotifen: A Case Report.

Shapiro Syndrome is a rare entity defined by the triad of recurrent spontaneous hypothermia, hyperhidrosis, and agenesis of the corpus callosum. Fewer than 100 cases have been reported so far and there are only few cases without a complete agenesis of corpus callosum ("Shapiro Syndrome Variant"). In this article, we report the clinical, electroencephalographic, and neuroimaging data of a patient with early-onset Shapiro Syndrome Variant.

Childhood disintegrative disorder: distinction from autistic disorder and predictors of outcome.

Childhood disintegrative disorder, a rare, relentlessly progressive neurologic disorder, first described by Heller in 1908, remains a condition of great interest. It has long been debated whether it is a discrete disorder or simply a late-onset variant of childhood autism. We have studied 6 cases of childhood disintegrative disorder, collected over 8 years, and followed for 2.

Normal "suspicious" EEG.

The EEG is a unique measure of electrical brain function and is widely used in patients with seizures. Many normal variants and variations of normal EEG have a predilection for the temporal lobe and mimic epileptiform discharges. The high prevalence of temporal lobe epilepsy and the propensity for normal variants to occupy the temporal lobe may result in an undesired bias, leading to misidentification of normal waveforms.

Artifact-related epilepsy.

Potentials that do not conform to an expected electrical field generated by the brain characterize an extracerebral source or artifact. Artifact is present in virtually every EEG. It is an essential component for routine visual analysis, yet it may beguile the interpreter into falsely identifying waveforms that simulate epileptiform discharges (ED).

[Electroencephalographic normal variants or with uncertain significance].

Electroencephalography is an important tool in the diagnosis of primary or secondary disorders of central nervous system, epilepsy is one of the most important. Sometimes normal electroencephalographic activity simulates epileptiform activity. This activity does not have pathological value and is considered a variant of normal brain activity.

[Significance of the EEG in the diagnosis of epilepsy].

The electroencephalogram (EEG) is a specific diagnostic method for the evaluation of patients with epilepsies. Interictal epileptiform discharges (IED) recorded in the seizure interval have a high association with the clinical diagnosis of epilepsy. IEDs have to be differentiated from normal variants that resemble IEDs.

Physiologic pseudoseizures: an EEG case report of mistake in identity.

The misdiagnosis of epilepsy may occur from the misinterpretation of a routine scalp EEG. Typically, interictal epileptiform discharges are misidentified on EEGs because of the overinterpretation of normal variants or variations in normal electrocerebral activity. Most reports of misinterpretation have arisen from patients diagnosed with psychogenic nonepileptic attacks using in-patient video-EEG monitoring.

Web-based collection of expert opinion on routine scalp EEG: software development and interrater reliability.

Computerized detection of epileptiform transients (ETs), characterized by interictal spikes and sharp waves in the EEG, has been a research goal for the last 40 years. A reliable method for detecting ETs would assist physicians in interpretation and improve efficiency in reviewing long-term EEG recordings. Computer algorithms developed thus far for detecting ETs are not as reliable as human experts, primarily due to the large number of false-positive detections.

Audit of EEG reporting temporal abnormalities.

Background: To ensure the overall quality of our electroencephalogram (EEG) laboratory, we decided to perform an audit of EEGs interpreted at our institution, focusing initially on EEGs reporting temporal abnormalities.

Methods: Reports of all EEGs performed between January 1st and June 30th, 2006 were reviewed in order to identify tracings mentioning abnormalities in the temporal regions. These records were then independently reviewed by two epileptologists on two distinct occasions, separated by an interval of at least six months.

[Clinical and neurophysiological manifestations of cerebral asymmetry in cervical dystonia].

Based on the analysis of clinical and neurophysiological data with the use of up-to-date methods of EEG processing, the authors discuss a role of cerebral asymmetry (CA) in the pathogenesis of cervical dystonia (CD). Sixty-seven patients (31 male and 36 female) with CD have been studied. The pathological turn of the head to the right side (RT) was observed in 34 patients, to the left side (LT) - in 33 patients.

Wicket spikes misinterpreted as focal abnormalities in idiopathic generalized epilepsy with prescription of carbamazepine leading to paradoxical aggravation.

Wicket spikes (WS) are a normal variant EEG pattern that sometimes can be mistaken for epileptiform activity. We present a patient with WS and idiopathic generalized epilepsy who had been wrongly diagnosed with focal epilepsy, which leads to the prescription of carbamazepine with severe aggravation of generalized tonic-clonic seizures. She was referred for presurgical assessment of refractory focal epilepsy but long-term video-EEG showed sharp theta waves over the temporal regions during awakening, with a typical aspect of WS during drowsiness, nREM sleep stages I-II, and rapid eye movements (REM) sleep.

Asymmetric POSTS associated with unilateral EEG abnormalities.

Objective: Positive occipital sharp transient of the sleep (POSTS) are considered a normal variant of non-REM sleep EEG. We describe a small series of patients with asymmetric POSTS and ipsilateral abnormal EEG findings.

Methods: Over a period of 30 weeks, we prospectively observed five consecutive subjects with strictly unilateral POSTS associated with ispilateral electrographic abnormalities.

Positive occipital sharp transients of sleep (POSTS): a reappraisal.

Objective: Positive occipital sharp transients of sleep (POSTS) are considered a normal variant seen in non-REM sleep; their asymmetrical presentation and relationship with EEG abnormalities have received scarce attention to date. We analyzed these features in a large prospective EEG recordings' sample.

Methods: In this case-control study, over 6 months we collected consecutive patients showing POSTS on their EEG.

Estimation of time-varying connectivity patterns through the use of an adaptive directed transfer function.

Frequency-derived identification of the propagation of information between brain regions has quickly become a popular area in the neurosciences. Of the various techniques used to study the propagation of activation within the central nervous system, the directed transfer function (DTF) has been well used to explore the functional connectivity during a variety of brain states and pathological conditions. However, the DTF method assumes the stationarity of the neural electrical signals and the time invariance of the connectivity among different channels over the investigated time window.

Normal adult EEG and patterns of uncertain significance.

A thorough understanding of a normal EEG is critical in defining those patterns that are abnormal. Because EEG is unique in the ability to support a clinical diagnosis of epilepsy, epileptiform patterns merit careful consideration. Certain benign patterns maybe epileptiform, yet can occur in healthy individuals without epilepsy.

[Epilepsy with electrical status epilepticus during slow sleep: diagnostic criteria and approaches to therapy].

Fourteen patients, aged from 5 to 14 years, with syndrome of electrical status epilepticus during slow sleep (ESESS) have been studied. The absence of epileptic attacks was observed in 21.5% of patients and diagnosis was established by a combination of continuous diffuse epileptiform activity with marked cognitive disturbances.

Megalencephaly and perisylvian polymicrogyria with postaxial polydactyly and hydrocephalus: a rare brain malformation syndrome associated with mental retardation and seizures.

Background And Objective: Megalencephaly (MEG) or enlarged brain occurs as a mild familial variant with normal brain structure, but otherwise is an uncommon human brain malformation that may be associated with significant developmental and neurological problems. It has been classified into anatomic and metabolic subtypes. The clinical findings associated with anatomic megalencephaly have been variable and few distinct subtypes have been described.

Overintepretation of EEGs and misdiagnosis of epilepsy.

The overinterpretation of EEGs is a known problem that has not been reported specifically. The authors report a series of EEGs on patients who were diagnosed eventually with psychogenic nonepileptic seizures and who had an EEG read as epileptiform. Of the 15 actual records available for review, the overread patterns were wicket spikes (n = 1), hypnagogic hypersynchrony (n = 1), and hyperventilation-induced slowing (n = 1).

A case-control study of a benign electroencephalographic variant pattern.

Wicket spikes (WS) are a benign electroencephalogram (EEG) variant, seen mainly in adults, during somnolence, in the temporal regions, in many clinical situations. WS can appear in trains or isolatedly, sometimes being difficult to differentiate from epileptiform activity. We reviewed 2,000 EEG's, found 65 with WS (3.