Jun 2026· I P Pavlov Russian Medical Biological Herald· Vol 34, pp. 261-267· 0 citations· 17 references
TL;DR
Correlates and predictors of the presence of epileptic seizures in patients with BEDC on the EEG can be the neurophysiological parameters of stimulus recognition based on P300 potential and average alpha rhythm frequency data.
Abstract
Background
Eight to 12% of patients with benign epileptiform discharges of childhood (BEDC) on the electroencephalogram (EEG) develop epileptic seizures. A significant proportion of these patients have cognitive impairment. The issue of determining comprehensive predictors of epileptic seizures and cognitive impairment in patients with BEDC on the EEG remains unresolved.
Aim
To analyze the relationship between BEDC and epileptic seizures and also to evaluate their impact on the cognitive status of patients.
Methods
The study involved 99 patients aged from 5 to 15 years (61 boys and 38 girls, mean age 9.3 years, standard error of the mean 0.23) with epileptic seizures (n = 57) and without them (n = 42). The following epilepsy types were recorded: age-dependent focal (n = 33, 58%), structural focal (n = 10, 18%), epileptic encephalopathy (n = 14, 24%). After therapy adjustment, patients received 1 anticonvulsant (54%), 2 anticonvulsants (26%), or 3 anticonvulsants (19%). The following anticonvulsants (in duo- and polytherapy, the main prescribed anticonvulsant was specified at the highest dose) were used: lamotrigine (n = 8), levetiracetam (n = 24), valproic acid (n = 13); in single cases, in combination with other drugs: ethosuximide (n = 2), topiramate (n = 1), oxcarbazepine (n = 1). The cognitive sphere was assessed on the EpiTrack Junior test scales, the P300 potential was recorded in the oddball paradigm.
Results
The group of patients with epileptic seizures demonstrated a lower total score in the 'Words' test (4 [3; 5] versus 5 [4; 5]), the higher power of theta- and alpha-oscillations and lower frequency of alpha-oscillations on the EEG; in the same group, higher latency of N2 component of P300 was identified in Fz. The association between the number of taken anticonvulsants and the extent of cognitive impairments was assessed: children receiving 3 anticonvulsants showed lower scores on scale 1 of the EpiTrack test (2 [1; 3]) compared to children taking 1 or 2 anticonvulsants (4 [3; 5] and 4 [1; 5] respectively). The lowest results were recorded in patients receiving preparations of valproic acid. Logit regression analysis of neurophysiological parameters: χ2 indicator for the model was 8.7; p = 0.013; Hook–Jeevis estimation method; loss function — maximum likelihood; the number of correct classifications into group 1 was 86%, into group 2 — 69%; odds ratio — 4.52.
Conclusions
Correlates and predictors of the presence of epileptic seizures in patients with BEDC on the EEG can be the neurophysiological parameters of stimulus recognition based on P300 potential and average alpha rhythm frequency data. In patients with BEDC on the EEG and manifestation of epileptic seizures, the most pronounced cognitive impairment was observed in the group of patients with epileptic encephalopathy and structural focal epilepsy.
Background
. Psychogenic non-epileptic seizures are episodes involving changes in motor activity, emotions, sensations, or actions that resemble epileptic seizures but are not accompanied by epileptiform changes on the electroencephalogram.
Objective
. To study the frequency and characteristics of psychogenic non-epileptic seizures (PNES) in paediatric neurosurgical patients with drug-resistant epilepsy (DRE).
Design and methods
. This is a single-centre, retrospective, uncontrolled, open-label observational study-part of an assignment of the M0H of the RF No.126020916808-7. All patients in the paediatric neurosurgery department diagnosed with DRE were included over a one-year period. The clinical and sociodemographic characteristics of DRE in the paediatric neurosurgery department, as well as the frequency and characteristics of PNES among patients in the neurosurgery department, were studied.
Results
. In total, 58 children diagnosed with epilepsy were hospitalised in 2021. Group1 included 56 patients of both sexes, DRE without PNES; the mean age was 9.5±0.6 years. The gender ratio was boysto-girls = 1:1,2. The mean age at epilepsy onset was 4.3±0.62 years. Epilepsy onset before 3 years of age was observed in 27 children, of whom 24 had onset before 1 year. 11 children had onset between 3 and 7 years, 12 between 8 and 11 years, and 4 between 12 and 18 years. PNES were detected in 2 patients in Group2, with a boys-to-girls ratio = 1:1. A clinical example of PNES diagnosis in a 16-year-old girl with DRE is presented.
Conclusion
. Psychogenic non-epileptic seizures occurred in 3,5 % of children with epilepsy in a neurosurgical hospital. The gold standard for diagnosis is neurophysiological examination demonstrating absence of epileptiform activity during a seizure.
T. B. Bazarhandaeva, A. Kim, N. E. Ivanova et al.· Russian Journal for Personal...· 0 citations
Generalized seizures with tonic clonic presentation were most common seizure type reported and were classified according to International League Against Epilepsy classification 1989.
Dr. Devanand Gulab, PraveenSingh Chaudhary, Dr.Ashwini Mohan et al.· PAIN, JOINTS, SPINE· 0 citations
The timely detection of cognitive impairment in pediatric epilepsy is a pressing issue in neurological practice. This study examined cognitive changes in children aged 5 to 17 years (inclusive) with temporal lobe epilepsy (26 subjects) and self-limited epilepsy with centrotemporal spikes (22 subjects). The control group consisted of 32 healthy volunteers aged 6 to 17 years (inclusive). A comparative analysis of cognitive testing results using the Wechsler cognitive assessment (child and adult versions) revealed multiple changes in verbal and nonverbal functions in patients with epilepsy compared to the control group. Patients with self-limited epilepsy with centrotemporal spikes also showed more pronounced changes in verbal IQ, with scores decreasing relative to the group of patients with temporal lobe epilepsy and the control group. A correlation was also noted between a right-sided focus of epileptiform activity and statistically significantly lower scores on the nonverbal IQ subtests. Similarities in cognitive profile changes were also observed in patients with genetic and structural focal epilepsy. However, the diffuse changes revealed by the test results were consistent with normal IQ scores. The findings demonstrate the widespread influence of epileptogenic processes on the development of cognitive functions, as well as the high compensatory capacity of children. Thus, neuropsychological examination of children with epilepsy already at the early stages of the disease can reveal deviations in the development of cognitive status, which can significantly affect the further development and socialization of pediatric patients and necessitates the organization of neuropsychological screening for this pathology.
A. Paramonova, A. A. Vasilieva, Е. Е. Timechko et al.· Vestnik of North-Eastern Fed...· 0 citations
OBJECTIVE
The objective of this study was to evaluate the frequency, electroclinical course and prognosis of patients with CAE that also present with centrotemporal spikes.
METHODS
This was a retrospective study based on chart review. Patients with diagnosis of CAE and seizure onset < 10 years-old were included. Patients with developmental delay, abnormal EEG background, atypical absence, generalized tonic-clonic, myoclonic or eyelid myoclonic seizures were excluded.
RESULTS
276 patients with CAE were included; 25 (9%) had at least one EEG showing centrotemporal spikes. Age of absence seizure onset ranged from 3 to 10 years-old (mean = 6 years-old). Absence seizures were controlled in all patients treated with antiseizure medication (ASM). CAE evolved to other type of idiopathic generalized epilepsy in four (16%) patients. No patient had generalized tonic-clonic seizures, except those with evolution to other type of idiopathic generalized epilepsy. No patient had focal seizures. Remission of the generalized epileptiform discharges correlated with ASM treatment in 95.5% of the patients, whereas centrotemporal epileptiform discharges persisted in 59%. Follow-up ranged from 1 to 16 years (mean = 6 years; median = 6 years).
CONCLUSION
Centrotemporal spikes were identified in 9% of patients with CAE. Focal seizures were not seen, suggesting that it reflects an EEG trait. Remission of the generalized epileptiform discharges correlates with ASM treatment and seizure outcome is excellent, despite persistence of centrotemporal spikes.
María Augusta Montenegro, Shifteh Sattar, M. Nespeca et al.· Epilepsy & Behavior· 0 citations
INTRODUCTION
Benign epileptiform variants (BEV) are uncommon epileptiform-like EEG graphoelements that do not meet diagnostic criteria for epileptiform or pathological discharges. The clinical significance of some subtypes remains uncertain.
METHODS
We conducted a single-centre, retrospective, observational study of 57 408 EEG recordings from 32 349 patients who were followed up for more than one year. We determined the prevalence of each BEV and compared the presence of epilepsy at baseline and at the end of follow-up.
RESULTS
BEV were identified in 192 patients (287 EEG recordings), yielding a prevalence of 0.58% in the total cohort and 1.26% among patients with otherwise normal EEG recordings (n = 15 172). Diagnosis of epilepsy was observed in 39% of patients with BEV at baseline and 35% of patients with BEV after a mean follow-up of 7.4 years. In subtype-based analyses, the 6-Hz spike-and-wave bursts subtype was significantly associated with a higher prevalence of epilepsy at baseline (OR: 12.3; 95% CI, 1.47-103.2; P = .021), and the small sharp spikes variant was associated with a higher prevalence of focal epilepsy at the end of follow-up (OR: 3.05; 95% CI, 1.43-6.50; P = .004), as compared to other BEV. In contrast, wicket spikes were associated with a lower presence of epilepsy (OR: 0.31; 95% CI, 0.13-0.72; P = .007) than other BEV.
CONCLUSIONS
BEV are infrequent, heterogeneous EEG findings. Correct recognition, particularly of wicket spikes, may prevent overdiagnosis and unnecessary treatment. Overall, they lack pathological significance, although 6-Hz spike-and-wave bursts and small sharp spikes showed a stronger association with epilepsy and may be considered variants of uncertain significance warranting clinical follow-up.
R. A. S. Díaz, S. B. Cuéllar, Jesús González de la Aleja Tejera et al.· Neurología· 0 citations
Early-onset epilepsy in infancy exhibits heterogeneous features and the ILAE framework facilitates a systematic diagnostic approach and supports clinical management in pediatric patients.
