Clinical and Electroencephalographic Evidence for Sites of Origin of Seizures with Diffuse Electrodecremental Pattern |
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Authors: | Santiago Arroyo Ronald P Lesser†‡ Robert S Fisher† Eileen P Vining§ Gregory L Krauss Karen Bandeen-Roche John Hart Barry Gordon Sumio Uematsu† Robert Webber† |
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Institution: | Department of Neurology, The Johns Hopkins Epilepsy Center;Department of Neurosurgery, The Johns Hopkins University School of Medicine;The Zanvyl Krieger MindlBrain Institute, The Johns Hopkins University School of Medicine;Department of Pediatrics, The Johns Hopkins University School of Medicine;Department of Biostatistics, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, U.S.A. |
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Abstract: | Summary: A diffuse electrodecremental ictal pattern with other forms of epilepsy and has been considered to reflect a generalized seizure disorder of diffuse cortical or subcortical (brainstem) origin. In some seizures associated with DEP, however, focal ictal manifestations have been observed. We reviewed the records of all patients admitted to our seizure monitoring unit for 3 years and detected 39 patients with seizures associated with DEP. In 23 of 39 patients, clinical ictal behaviors resembled seizures of unilateral supero/mesiofrontal lobe origin and interictal EEG showed a prominent unilateral frontal component. Nine of 39 had complex absences (CA)/complex partial seizures (CPS); 4 of them were of unilateral frontal lobe origin. Seven of 39 patients had tonic or atonic seizures. Seven patients were studied further with subdural electrodes. Ictal onsets showed a highfrequency frontal lobe discharge. We conclude that in a subgroup of patients a generalized electrodecremental pattern on scalp EEG results from a regional cortical high-frequency ictal discharge originating in a single frontal lobe. |
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Keywords: | Epilepsy Electroencephalography Electrodecremental-Frontal lobe seizures Tonic seizures Supplementary motor area High-frequency activity Lennox Gastaut syndrome |
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