PURPOSE: The role of sharps and spikes, interictal epileptiform discharges (IEDs), in guiding epilepsy surgery in children remains controversial, particularly with intracranial electroencephalography (IEEG). Although ictal recording is the mainstay of localizing epileptic networks for surgical resection, current practice dictates removing regions generating frequent IEDs if they are near the ictal onset zone. Indeed, past studies suggest an inconsistent relationship between IED and seizure-onset location, although these studies were based upon relatively short EEG epochs. METHODS: We employ a previously validated, computerized spike detector to measure and localize IED activity over prolonged, representative segments of IEEG recorded from 19 children with intractable, mostly extratemporal lobe epilepsy. Approximately 8 h of IEEG, randomly selected 30-min segments of continuous interictal IEEG per patient, were analyzed over all intracranial electrode contacts. RESULTS: When spike frequency was averaged over the 16-time segments, electrodes with the highest mean spike frequency were found to be within the seizure-onset region in 11 of 19 patients. There was significant variability between individual 30-min segments in these patients, indicating that large statistical samples of interictal activity were required for improved localization. Low-voltage fast EEG at seizure onset was the only clinical factor predicting IED localization to the seizure-onset region. CONCLUSIONS: Our data suggest that automated IED detection over multiple representative samples of IEEG may be of utility in planning epilepsy surgery for children with intractable epilepsy. Further research is required to better determine which patients may benefit from this technique a priori.
PURPOSE: The role of sharps and spikes, interictal epileptiform discharges (IEDs), in guiding epilepsy surgery in children remains controversial, particularly with intracranial electroencephalography (IEEG). Although ictal recording is the mainstay of localizing epileptic networks for surgical resection, current practice dictates removing regions generating frequent IEDs if they are near the ictal onset zone. Indeed, past studies suggest an inconsistent relationship between IED and seizure-onset location, although these studies were based upon relatively short EEG epochs. METHODS: We employ a previously validated, computerized spike detector to measure and localize IED activity over prolonged, representative segments of IEEG recorded from 19 children with intractable, mostly extratemporal lobe epilepsy. Approximately 8 h of IEEG, randomly selected 30-min segments of continuous interictal IEEG per patient, were analyzed over all intracranial electrode contacts. RESULTS: When spike frequency was averaged over the 16-time segments, electrodes with the highest mean spike frequency were found to be within the seizure-onset region in 11 of 19 patients. There was significant variability between individual 30-min segments in these patients, indicating that large statistical samples of interictal activity were required for improved localization. Low-voltage fast EEG at seizure onset was the only clinical factor predicting IED localization to the seizure-onset region. CONCLUSIONS: Our data suggest that automated IED detection over multiple representative samples of IEEG may be of utility in planning epilepsy surgery for children with intractable epilepsy. Further research is required to better determine which patients may benefit from this technique a priori.
Authors: J M Paolicchi; P Jayakar; P Dean; I Yaylali; G Morrison; A Prats; T Resnik; L Alvarez; M Duchowny Journal: Neurology Date: 2000-02-08 Impact factor: 9.910
Authors: B Litt; R Esteller; J Echauz; M D'Alessandro; R Shor; T Henry; P Pennell; C Epstein; R Bakay; M Dichter; G Vachtsevanos Journal: Neuron Date: 2001-04 Impact factor: 17.173
Authors: Eishi Asano; Otto Muzik; Aashit Shah; Csaba Juhász; Diane C Chugani; Sandeep Sood; James Janisse; Eser Lay Ergun; Judy Ahn-Ewing; Chenggang Shen; Jean Gotman; Harry T Chugani Journal: Epilepsia Date: 2003-03 Impact factor: 5.864
Authors: Susan S Spencer; Irina I Goncharova; Robert B Duckrow; Edward J Novotny; Hitten P Zaveri Journal: Epilepsia Date: 2008-05-08 Impact factor: 5.864
Authors: A Palmini; I Najm; G Avanzini; T Babb; R Guerrini; N Foldvary-Schaefer; G Jackson; H O Lüders; R Prayson; R Spreafico; H V Vinters Journal: Neurology Date: 2004-03-23 Impact factor: 9.910
Authors: Cyrus Huang; Eric D Marsh; Daniela M Ziskind; Juanita M Celix; Bradley Peltzer; Merritt W Brown; Phillip B Storm; Brian Litt; Brenda E Porter Journal: J Pediatr Epilepsy Date: 2012
Authors: Daniel T Barkmeier; Aashit K Shah; Danny Flanagan; Marie D Atkinson; Rajeev Agarwal; Darren R Fuerst; Kourosh Jafari-Khouzani; Jeffrey A Loeb Journal: Clin Neurophysiol Date: 2011-10-26 Impact factor: 3.708
Authors: Joshua M Diamond; Julio I Chapeton; William H Theodore; Sara K Inati; Kareem A Zaghloul Journal: Clin Neurophysiol Date: 2019-07-02 Impact factor: 3.708