Do brief bursts of spike and wave activity cause a cerebral hyper- or hypoperfusion in man?

The correlation between brain activity and cerebral blood flow velocities during brief bursts of generalized spike and wave activity was analysed by simultaneous registration of the EEG and the intracranial flow patterns. The flow patterns of the middle cerebral artery were continuously recorded by means of transcranial Doppler ultrasonography using a specially developed monitoring system. A total of 25 bursts was investigated in 3 patients with spontaneous occurrence of generalized 3 Hz spike and wave activity and normal background EEG. Characteristic changes of the flow patterns were found in all cases: 3.41 +/- 0.98 s (n = 25) after the beginning of generalized spike and wave patterns, the flow velocity decreased by 25.84 +/- 10.45% (n = 25) below the 'preictal' flow velocity level. The period of flow velocity changes lasted several times longer than the phase of spike and wave activity.