Clinical staging and electroencephalographic evolution of continuous spikes and waves during sleep.
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| Title: | Clinical staging and electroencephalographic evolution of continuous spikes and waves during sleep. |
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| Authors: | Fernández, Iván Sánchez, Peters, Jurriaan M., Hadjiloizou, Stavros, Prabhu, Sanjay P., Zarowski, Marcin, Stannard, Karen M., Takeoka, Masanori, Rotenberg, Alexander, Kothare, Sanjeev V., Loddenkemper, Tobias |
| Source: | Epilepsia (Series 4). Jul2012, Vol. 53 Issue 7, p1185-1195. 11p. |
| Subjects: | Electroencephalography, Epilepsy, Neuropsychology, Brain imaging, Statistical correlation, Diagnosis of brain diseases |
| Abstract: | Purpose: Currently, in continuous spikes and waves during sleep (CSWS) there is a lack of systematic assessments of the clinically relevant stages and the evolution of the electroencephalographic features. The aim of this study is to describe the evolution over time of clinical and electroencephalographic features in CSWS. Methods: We enrolled patients from our video-electroencephalography (EEG) monitoring unit with CSWS and with overnight EEG studies with at least one overnight assessment per year over a minimum period of 3 years. We studied clinical presentation and electroencephalographic features. We calculated the (1) spike-wave percentage (SWP) as the percentage of 1-s bins containing at least one spike-wave complex and (2) spike frequency (SF) as the number of spikes per 100 s. Key Findings: Nine children (six boys) met the inclusion criteria during a 15-year period. Seven (78%) had an abnormal development prior to the epilepsy onset, and in two (22%) seizures were the only presenting symptom. Median age at epilepsy onset was 2 years (range 2 days to 4 years), at neuropsychological regression 5.1 years (4-7.7 years), and at seizure freedom 8.6 years (6.5-11.4 years). Median duration and range of clinically relevant stages were as follows: dormant stage (birth-epilepsy onset median 2 years, range 2 days-4 years), prodromal stage (epilepsy onset-neuropsychological regression 3.9 years, range 0.9-7.7 years), acute stage (neuropsychological regression-seizure freedom 2.9 years, range 2.1-6.6 years), and residual stage (after seizure freedom). Seven patients (78%) had a structural lesion on neuroimaging. At last follow-up (median 11.4 years, range 7.2-20.3 years), eight patients (89%) were receiving antiepileptic treatment, and all patients had residual neurocognitive deficits. During the acute stage, SWP was <85% in 13 (42%) of 31 assessments, and after seizure freedom, 3 of 5 patients (60%) had SWP >85%. Evolution of electroencephalographic patterns included increasing-decreasing, continuously elevated, and fluctuating patterns (33.3% each). There was good correlation between SWP and SF (Spearman correlation-coefficient = 0.942; p < 0.0001). SF, which can exceed 100%, reflected changes in electroencephalography pattern in more detail than SWP, which cannot exceed 100% and therefore has a ceiling effect. Significance: Our series systematically studied the age of occurrence of the significant clinical events. These may assist in defining clinical stages, which can provide a useful framework for future clinical trials in patients with CSWS. The severity of the epileptiform discharges on EEG did not always correlate with seizure frequency and severity; epileptiform discharges could be prominent after seizure freedom and fluctuated along the course of the disease. The values of SWP and SF correlated well, but SWP based on 1-s bins has the potential disadvantage of a ceiling effect. [ABSTRACT FROM AUTHOR] |
| Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Items | – Name: Title Label: Title Group: Ti Data: Clinical staging and electroencephalographic evolution of continuous spikes and waves during sleep. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Fernández%2C+Iván+Sánchez%22">Fernández, Iván Sánchez</searchLink><br /><searchLink fieldCode="AR" term="%22Peters%2C+Jurriaan+M%2E%22">Peters, Jurriaan M.</searchLink><br /><searchLink fieldCode="AR" term="%22Hadjiloizou%2C+Stavros%22">Hadjiloizou, Stavros</searchLink><br /><searchLink fieldCode="AR" term="%22Prabhu%2C+Sanjay+P%2E%22">Prabhu, Sanjay P.</searchLink><br /><searchLink fieldCode="AR" term="%22Zarowski%2C+Marcin%22">Zarowski, Marcin</searchLink><br /><searchLink fieldCode="AR" term="%22Stannard%2C+Karen+M%2E%22">Stannard, Karen M.</searchLink><br /><searchLink fieldCode="AR" term="%22Takeoka%2C+Masanori%22">Takeoka, Masanori</searchLink><br /><searchLink fieldCode="AR" term="%22Rotenberg%2C+Alexander%22">Rotenberg, Alexander</searchLink><br /><searchLink fieldCode="AR" term="%22Kothare%2C+Sanjeev+V%2E%22">Kothare, Sanjeev V.</searchLink><br /><searchLink fieldCode="AR" term="%22Loddenkemper%2C+Tobias%22">Loddenkemper, Tobias</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Jul2012, Vol. 53 Issue 7, p1185-1195. 11p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Electroencephalography%22">Electroencephalography</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychology%22">Neuropsychology</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+imaging%22">Brain imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+correlation%22">Statistical correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis+of+brain+diseases%22">Diagnosis of brain diseases</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Purpose: Currently, in continuous spikes and waves during sleep (CSWS) there is a lack of systematic assessments of the clinically relevant stages and the evolution of the electroencephalographic features. The aim of this study is to describe the evolution over time of clinical and electroencephalographic features in CSWS. Methods: We enrolled patients from our video-electroencephalography (EEG) monitoring unit with CSWS and with overnight EEG studies with at least one overnight assessment per year over a minimum period of 3 years. We studied clinical presentation and electroencephalographic features. We calculated the (1) spike-wave percentage (SWP) as the percentage of 1-s bins containing at least one spike-wave complex and (2) spike frequency (SF) as the number of spikes per 100 s. Key Findings: Nine children (six boys) met the inclusion criteria during a 15-year period. Seven (78%) had an abnormal development prior to the epilepsy onset, and in two (22%) seizures were the only presenting symptom. Median age at epilepsy onset was 2 years (range 2 days to 4 years), at neuropsychological regression 5.1 years (4-7.7 years), and at seizure freedom 8.6 years (6.5-11.4 years). Median duration and range of clinically relevant stages were as follows: dormant stage (birth-epilepsy onset median 2 years, range 2 days-4 years), prodromal stage (epilepsy onset-neuropsychological regression 3.9 years, range 0.9-7.7 years), acute stage (neuropsychological regression-seizure freedom 2.9 years, range 2.1-6.6 years), and residual stage (after seizure freedom). Seven patients (78%) had a structural lesion on neuroimaging. At last follow-up (median 11.4 years, range 7.2-20.3 years), eight patients (89%) were receiving antiepileptic treatment, and all patients had residual neurocognitive deficits. During the acute stage, SWP was <85% in 13 (42%) of 31 assessments, and after seizure freedom, 3 of 5 patients (60%) had SWP >85%. Evolution of electroencephalographic patterns included increasing-decreasing, continuously elevated, and fluctuating patterns (33.3% each). There was good correlation between SWP and SF (Spearman correlation-coefficient = 0.942; p < 0.0001). SF, which can exceed 100%, reflected changes in electroencephalography pattern in more detail than SWP, which cannot exceed 100% and therefore has a ceiling effect. Significance: Our series systematically studied the age of occurrence of the significant clinical events. These may assist in defining clinical stages, which can provide a useful framework for future clinical trials in patients with CSWS. The severity of the epileptiform discharges on EEG did not always correlate with seizure frequency and severity; epileptiform discharges could be prominent after seizure freedom and fluctuated along the course of the disease. The values of SWP and SF correlated well, but SWP based on 1-s bins has the potential disadvantage of a ceiling effect. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1528-1167.2012.03507.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 1185 Subjects: – SubjectFull: Electroencephalography Type: general – SubjectFull: Epilepsy Type: general – SubjectFull: Neuropsychology Type: general – SubjectFull: Brain imaging Type: general – SubjectFull: Statistical correlation Type: general – SubjectFull: Diagnosis of brain diseases Type: general Titles: – TitleFull: Clinical staging and electroencephalographic evolution of continuous spikes and waves during sleep. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Fernández, Iván Sánchez – PersonEntity: Name: NameFull: Peters, Jurriaan M. – PersonEntity: Name: NameFull: Hadjiloizou, Stavros – PersonEntity: Name: NameFull: Prabhu, Sanjay P. – PersonEntity: Name: NameFull: Zarowski, Marcin – PersonEntity: Name: NameFull: Stannard, Karen M. – PersonEntity: Name: NameFull: Takeoka, Masanori – PersonEntity: Name: NameFull: Rotenberg, Alexander – PersonEntity: Name: NameFull: Kothare, Sanjeev V. – PersonEntity: Name: NameFull: Loddenkemper, Tobias IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 07 Text: Jul2012 Type: published Y: 2012 Identifiers: – Type: issn-print Value: 00139580 Numbering: – Type: volume Value: 53 – Type: issue Value: 7 Titles: – TitleFull: Epilepsia (Series 4) Type: main |
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