Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy

Amna Al-Futaisi, Brenda Banwell, Ayako Ochi, Justine Hew, Bill Chu, Makoto Oishi, Hiroshi Otsubo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: We report on a 27-month-old female with atypical early infantile epileptic encephalopathy (EIEE), who developed tonic spasms, partial seizures and myoclonic jerks along with episodic bradycardia at 5 days. Methods: We recorded digital electroencephalography (EEG) using either an 11-channel neonatal montage or 19 channel scalp electrodes, at 200 Hz sampling rate, and a single reference for a minimum of 30 min. Results: At 18 days EEG showed suppression-burst (SB) patterns during wakefulness and sleep. Tonic spasms concomitant with bursts recorded as brief, low-amplitude fast waves. EEG at 8 months showed increased amplitude of bursts to 1 mV and extension of suppression periods to 65 s. By increasing recording sensitivity, we detected focal epileptiform discharges of slow rhythmic sharp and slow waves building to 30 μV during suppression periods. Status epilepticus occurred at 16 months. EEG at 27 months returned to the previous SB pattern with rare partial seizures. Conclusions: This report is the first to demonstrate clinically silent focal EEG seizures during prolonged suppression periods in atypical EIEE by off-line digital EEG. Significance: Digital EEG sensitivity can reveal covert electrical activity during suppression periods in epileptic neonates and infants.

Original languageEnglish
Pages (from-to)1113-1117
Number of pages5
JournalClinical Neurophysiology
Volume116
Issue number5
DOIs
Publication statusPublished - May 2005

Fingerprint

Brain Diseases
Electroencephalography
Seizures
Spasm
Myoclonus
Status Epilepticus
Wakefulness
Bradycardia
Scalp
Sleep
Electrodes
Newborn Infant

Keywords

  • Digital EEG
  • Early infantile epileptic encephalopathy
  • Hidden focal EEG seizure
  • Interictal discharge
  • Suppression-burst pattern

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems

Cite this

Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy. / Al-Futaisi, Amna; Banwell, Brenda; Ochi, Ayako; Hew, Justine; Chu, Bill; Oishi, Makoto; Otsubo, Hiroshi.

In: Clinical Neurophysiology, Vol. 116, No. 5, 05.2005, p. 1113-1117.

Research output: Contribution to journalArticle

Al-Futaisi, Amna ; Banwell, Brenda ; Ochi, Ayako ; Hew, Justine ; Chu, Bill ; Oishi, Makoto ; Otsubo, Hiroshi. / Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy. In: Clinical Neurophysiology. 2005 ; Vol. 116, No. 5. pp. 1113-1117.
@article{40301b75f92942778b7c3aaf70191721,
title = "Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy",
abstract = "Objective: We report on a 27-month-old female with atypical early infantile epileptic encephalopathy (EIEE), who developed tonic spasms, partial seizures and myoclonic jerks along with episodic bradycardia at 5 days. Methods: We recorded digital electroencephalography (EEG) using either an 11-channel neonatal montage or 19 channel scalp electrodes, at 200 Hz sampling rate, and a single reference for a minimum of 30 min. Results: At 18 days EEG showed suppression-burst (SB) patterns during wakefulness and sleep. Tonic spasms concomitant with bursts recorded as brief, low-amplitude fast waves. EEG at 8 months showed increased amplitude of bursts to 1 mV and extension of suppression periods to 65 s. By increasing recording sensitivity, we detected focal epileptiform discharges of slow rhythmic sharp and slow waves building to 30 μV during suppression periods. Status epilepticus occurred at 16 months. EEG at 27 months returned to the previous SB pattern with rare partial seizures. Conclusions: This report is the first to demonstrate clinically silent focal EEG seizures during prolonged suppression periods in atypical EIEE by off-line digital EEG. Significance: Digital EEG sensitivity can reveal covert electrical activity during suppression periods in epileptic neonates and infants.",
keywords = "Digital EEG, Early infantile epileptic encephalopathy, Hidden focal EEG seizure, Interictal discharge, Suppression-burst pattern",
author = "Amna Al-Futaisi and Brenda Banwell and Ayako Ochi and Justine Hew and Bill Chu and Makoto Oishi and Hiroshi Otsubo",
year = "2005",
month = "5",
doi = "10.1016/j.clinph.2004.12.010",
language = "English",
volume = "116",
pages = "1113--1117",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",
number = "5",

}

TY - JOUR

T1 - Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy

AU - Al-Futaisi, Amna

AU - Banwell, Brenda

AU - Ochi, Ayako

AU - Hew, Justine

AU - Chu, Bill

AU - Oishi, Makoto

AU - Otsubo, Hiroshi

PY - 2005/5

Y1 - 2005/5

N2 - Objective: We report on a 27-month-old female with atypical early infantile epileptic encephalopathy (EIEE), who developed tonic spasms, partial seizures and myoclonic jerks along with episodic bradycardia at 5 days. Methods: We recorded digital electroencephalography (EEG) using either an 11-channel neonatal montage or 19 channel scalp electrodes, at 200 Hz sampling rate, and a single reference for a minimum of 30 min. Results: At 18 days EEG showed suppression-burst (SB) patterns during wakefulness and sleep. Tonic spasms concomitant with bursts recorded as brief, low-amplitude fast waves. EEG at 8 months showed increased amplitude of bursts to 1 mV and extension of suppression periods to 65 s. By increasing recording sensitivity, we detected focal epileptiform discharges of slow rhythmic sharp and slow waves building to 30 μV during suppression periods. Status epilepticus occurred at 16 months. EEG at 27 months returned to the previous SB pattern with rare partial seizures. Conclusions: This report is the first to demonstrate clinically silent focal EEG seizures during prolonged suppression periods in atypical EIEE by off-line digital EEG. Significance: Digital EEG sensitivity can reveal covert electrical activity during suppression periods in epileptic neonates and infants.

AB - Objective: We report on a 27-month-old female with atypical early infantile epileptic encephalopathy (EIEE), who developed tonic spasms, partial seizures and myoclonic jerks along with episodic bradycardia at 5 days. Methods: We recorded digital electroencephalography (EEG) using either an 11-channel neonatal montage or 19 channel scalp electrodes, at 200 Hz sampling rate, and a single reference for a minimum of 30 min. Results: At 18 days EEG showed suppression-burst (SB) patterns during wakefulness and sleep. Tonic spasms concomitant with bursts recorded as brief, low-amplitude fast waves. EEG at 8 months showed increased amplitude of bursts to 1 mV and extension of suppression periods to 65 s. By increasing recording sensitivity, we detected focal epileptiform discharges of slow rhythmic sharp and slow waves building to 30 μV during suppression periods. Status epilepticus occurred at 16 months. EEG at 27 months returned to the previous SB pattern with rare partial seizures. Conclusions: This report is the first to demonstrate clinically silent focal EEG seizures during prolonged suppression periods in atypical EIEE by off-line digital EEG. Significance: Digital EEG sensitivity can reveal covert electrical activity during suppression periods in epileptic neonates and infants.

KW - Digital EEG

KW - Early infantile epileptic encephalopathy

KW - Hidden focal EEG seizure

KW - Interictal discharge

KW - Suppression-burst pattern

UR - http://www.scopus.com/inward/record.url?scp=17044388570&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17044388570&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2004.12.010

DO - 10.1016/j.clinph.2004.12.010

M3 - Article

C2 - 15826852

AN - SCOPUS:17044388570

VL - 116

SP - 1113

EP - 1117

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

IS - 5

ER -