33 results match your criteria Focal Nonepileptic Abnormalities on EEG

Focal bilateral motor seizures precipitated by abrupt cessation of chronic lormetazepam abuse and amitriptyline overdose.

Epilepsy Behav Rep 2021 31;15:100385. Epub 2020 Jul 31.

Neurology and Stroke Unit, San Francesco Hospital, Nuoro, Italy.

We report the case of an adult psychiatric patient who developed new-onset focal bilateral motor seizures (FBMS) in the context of a severe benzodiazepine withdrawal syndrome. The patient was forced to interrupt chronic lormetazepam abuse and overdosed on amitriptyline (800 mg in an oral solution) before the onset of seizures. Typical signs of amitriptyline intoxication such as sedation and anticholinergic effects were not observed. Read More

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Outcome of prolonged video-EEG monitoring in a new VA monitoring unit.

Epilepsy Behav 2020 01 3;102:106696. Epub 2019 Dec 3.

James A. Haley Veterans' Hospital, University of South Florida, United States of America. Electronic address:

Background And Objective: For patients with refractory seizures or seizure-like activity, prolonged inpatient video-electroencephalography (EEG) (v-EEG) is standard of care to guide diagnosis and management. The purpose of this study was to describe the outcome of v-EEG in a new Veterans' Administration (VA) hospital epilepsy monitoring unit (EMU).

Methods: We reviewed all prolonged (>24 h) inpatient v-EEGs performed in our EMU (2 beds) at the James A Haley VA in Tampa, FL over a five-and-a-half-year period (11/2013-07/2019). Read More

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January 2020

The epileptology of alternating hemiplegia of childhood.

Neurology 2019 09 4;93(13):e1248-e1259. Epub 2019 Sep 4.

From the Division of Pediatric Neurology, Duke University Health System, Duke University School of Medicine, Durham NC.

Objective: To report our experience and investigate 5 original hypotheses: (1) multiple types of epileptic seizures occur in alternating hemiplegia of childhood (AHC), and these can be the initial presentation; (2) epileptiform abnormalities often appear well after clinical seizures; (3) nonepileptic reduced awareness spells (RAS) occur frequently; (4) epilepsy is commonly drug resistant but may respond to vagal nerve stimulation (VNS); and (5) status epilepticus (SE) is common and is usually refractory and recurrent.

Methods: We analyzed a cohort of 51 consecutive patients with AHC.

Results: Thirty-two of 51 patients had epilepsy: 18 focal seizures, frontal more frequently than temporal, and then posterior. Read More

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September 2019

Adult EEG.

Handb Clin Neurol 2019 ;160:103-124

Department of Neurology, Mayo Clinic College of Medicine and Health Sciences, Jacksonville, FL, United States.

After more than 85 years of development and use in clinical practice, the electroencephalogram (EEG) remains a dependable, inexpensive, and useful diagnostic tool for the investigation of the electrophysiologic activity of the brain. The advent of digital technology has led to greater sophistication and multiple software applications to extend the utility of EEG beyond the confines of the laboratory. Despite the discovery of new waveforms, basic neurophysiologic principles remain essential to the clinical care of patients. Read More

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December 2019

POGZ-related epilepsy: Case report and review of the literature.

Am J Med Genet A 2019 08 28;179(8):1631-1636. Epub 2019 May 28.

Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

POGZ (# 614787) encodes a multidomain nuclear protein involved in transcriptional regulation and its defective function has been recently associated with a syndromic neurodevelopmental disorder, known as White-Sutton syndrome (# 616364). While originally epileptic seizures were unreported, it seems that epilepsy represents a recurrent feature in affected subjects. Few data, however, are available on electroclinical features of POGZ-related epilepsy. Read More

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Epileptological aspects of juvenile neuronal ceroid lipofuscinosis (CLN3 disease) through the lifespan.

Epilepsy Behav 2019 05 16;94:59-64. Epub 2019 Mar 16.

Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Purpose: Juvenile neuronal ceroid lipofuscinosis (CLN3 disease) is the most common neurodegenerative disorder in childhood with survival until young adult age. Visual loss is followed by epilepsy, cognitive, neuropsychiatric, and motor symptoms. We have studied the evolution of electroencephalographic (EEG) and seizure characteristics. Read More

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The forsaking of the clinical EEG by psychiatry: how justified?

Nash N Boutros

CNS Spectr 2018 06 2;23(3):196-204. Epub 2017 Aug 2.

University of Missouri in Kansas City,Kansas City,Missouri,USA.

Despite decades of publications attesting to the role of the clinical EEG in diagnosing and managing psychiatric disorders, the procedure remains highly underutilized in the practice of psychiatry. The visually inspected EEG (vEEG) can detect various forms of abnormalities, each with its own clinical significance. Abnormalities can be paroxysmal (i. Read More

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Diagnostic Yield of Routine Electroencephalography With Concurrent Video Recording in Detecting Interictal Epileptiform Discharges in Relation to Reasons for Request: A Prospective Study of 1,080 Video-Electroencephalograms.

J Clin Neurophysiol 2017 Sep;34(5):434-437

Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

Purpose: The aim of this study was to prospectively analyze the sensitivity and specificity of routine electroencephalography with concurrent video recording (vEEG) in relation to the reasons for requesting the test and to investigate when routine vEEG should be requested.

Methods: We prospectively analyzed 1,080 consecutive vEEGs performed between April 2015 and April 2016. The requests for vEEG were classified as requests with a low suspicion of epilepsy (syncope, confusion or delirium, suspicion of psychogenic nonepileptic seizures, and paroxysmal focal neurological deficit) or requests with a high suspicion of epilepsy (first clinical seizure, suspected status epilepticus, follow-up study of a patient with epilepsy, and acute symptomatic seizures). Read More

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September 2017

Diagnostic yield of ambulatory EEGs in the elderly.

Clin Neurophysiol 2017 07 29;128(7):1350-1353. Epub 2017 Jan 29.

Department of Neurology, The Edward B. Bromfield Epilepsy Program, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

Objective: The diagnostic yield of ambulatory EEG in the elderly is not known. We sought to determine diagnostic yield and identify factors predicting diagnostic findings in this elderly population.

Methods: We reviewed 156 consecutive 24-72h ambulatory EEGs performed on patients aged 60 or older. Read More

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Role of Short Term Video Encephalography with Induction by Verbal Suggestion in Diagnosis of Suspected Paroxysmal Nonepileptic Seizure-Like Symptoms.

Epilepsy Res Treat 2016 17;2016:2801369. Epub 2016 Nov 17.

Department of Neurology, Pramukhswami Medical College, Shree Krishna Hospital, Karamsad, Anand, Gujarat 388325, India.

. To determine the diagnostic yield and utility of STVEEG with verbal suggestion in diagnosis of patients presenting with transient unresponsiveness and suspected psychogenic nonepileptiform seizures. . Read More

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November 2016

Integration of EEG Into Psychiatric Practice: A Step Toward Precision Medicine for Autism Spectrum Disorder.

J Clin Neurophysiol 2017 May;34(3):230-235

*Tarnow Center for Self-Management, Houston, Texas, U.S.A.; †Network Neurology LLC, Charleston, South Carolina, U.S.A.; and ‡Department of Clinical Psychology, Saybrook University, Oakland, California, U.S.A.

Introduction: Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges are found to be more prevalent in psychiatric patients, particularly those diagnosed with autism spectrum disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side effects. Read More

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Generalized onset seizures with focal evolution (GOFE) - A unique seizure type in the setting of generalized epilepsy.

Epilepsy Behav 2016 Jan 25;54:20-9. Epub 2015 Nov 25.

Department of Neurology, Vanderbilt University, Nashville, TN, USA. Electronic address:

Purpose: We report clinical and electrographic features of generalized onset seizures with focal evolution (GOFE) and present arguments for the inclusion of this seizure type in the seizure classification.

Methods: The adult and pediatric Epilepsy Monitoring Unit databases at Vanderbilt Medical Center and Children's Hospital were screened to identify generalized onset seizures with focal evolution. We reviewed medical records for epilepsy characteristics, epilepsy risk factors, MRI abnormalities, neurologic examination, antiepileptic medications before and after diagnosis, and response to medications. Read More

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January 2016

Interval analysis of interictal EEG: pathology of the alpha rhythm in focal epilepsy.

Sci Rep 2015 Nov 10;5:16230. Epub 2015 Nov 10.

Department of Adult Neurology, Medical University of Gdansk, Poland.

The contemporary use of interictal scalp electroencephalography (EEG) in the context of focal epilepsy workup relies on the visual identification of interictal epileptiform discharges. The high-specificity performance of this marker comes, however, at a cost of only moderate sensitivity. Zero-crossing interval analysis is an alternative to Fourier analysis for the assessment of the rhythmic component of EEG signals. Read More

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November 2015

MRI-identified pathology in adults with new-onset seizures.

Neurology 2013 Sep 7;81(10):920-7. Epub 2013 Aug 7.

Melbourne Brain Centre, Department of Medicine, The Royal Melbourne Hospital and the Epilepsy Research Centre, Department of Medicine, The University of Melbourne, Australia.

Objective: To determine the frequency and nature of potentially epileptogenic lesions on MRI in adults with new-onset seizures.

Methods: We prospectively studied a consecutive series of 993 patients (597 males [61%]; mean [SD] age: 42.2 [18. Read More

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September 2013

Frequency of epileptiform discharges in the sleep-deprived electroencephalogram in children evaluated for attention-deficit disorders.

J Child Neurol 2011 Jan 17;26(1):6-11. Epub 2010 Aug 17.

Children's Memorial Hospital, Northwestern University Medical School, Chicago, IL, USA.

The authors determined the frequency of epileptiform discharges in the electroencephalogram (EEG) of a cohort of children and adolescents referred to a neurology specialty clinic for evaluation of attention-deficit disorders. Of 624 records, 461 (73.9%) were normal and 163 (26. Read More

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January 2011

Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.

Neurology 2006 Nov;67(9):1542-50

Division of Epilepsy and Clinical Neurophysiology and the Critical Care Neurology Service, Department of Neurology, Children's Hospital, Boston, MA, USA.

Objective: To review evidence on the assessment of the child with status epilepticus (SE).

Methods: Relevant literature were reviewed, abstracted, and classified. When data were missing, a minimum diagnostic yield was calculated. Read More

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November 2006

Interictal, potentially misleading, epileptiform EEG abnormalities in REM sleep behavior disorder.

Sleep 2006 Jul;29(7):934-7

Unit of Sleep Medicine and Epilepsy, IRCCS C. Mondino Institute of Neurology Foundation, Pavia, Italy.

Study Objectives: To examine the implications of interictal epileptiform abnormalities (IEA) in idiopathic REM-sleep behavior disorder (RBD), particularly the risk of misdiagnosing RBD episodes as epileptic nocturnal seizures.

Design: Observational analysis and review.

Setting: Tertiary sleep center. Read More

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Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center.

Epilepsia 2006 Feb;47(2):394-8

Department of Neurology, University of California at Irvine College of Medicine, UCI Medical Center, 101 The City Drive, Orange, CA 92868, U.S.A.

Purpose: Children with autism are commonly referred for video-EEG monitoring to determine the precise nature of their seizure-like events.

Methods: We studied 32 children with autism by using continuous video-EEG telemetry (VEEG) monitoring at a tertiary care referral center.

Results: Of the 32 total patients, 22 were primarily referred for seizure evaluation and 10 for 24-h interictal EEG recording. Read More

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February 2006

Comparison of epileptic and nonepileptic cases with centrotemporal spikes in view of clinical findings and electroencephalographic characteristics.

Int J Neurosci 2006 Mar;116(3):299-313

Department of Neurology Faculty of Medicine, Yüzüncü Yil University, Van, Turkey.

The morphological features of centrotemporal spike discharges (CTSD) and relationship of them with clinical diagnosis in cases with benign epilepsy of childhood with centrotemporal spikes (BECTS) and the other epileptic syndromes of childhood as well as some nonconvulsive neurological disorders were detected in the routine patient population who referred to the authors' EEG laboratory. Thirty-six cases (21 males, 15 females; 8 months-14 years old), in which awake and/or sleep EEGs revealed CTSD were included in this study. The cases were divided into two groups as epileptic and nonepileptic. Read More

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Value of the early electroencephalogram after a first unprovoked seizure.

Clin Electroencephalogr 2003 Jul;34(3):140-4

Department of Neurology, Klinikum Mannheim, University of Heidelberg, Germany.

Studies on the predictive value of the electroencephalogram (EEG) concerning the risk of seizure recurrence have shown contradictory results. We prospectively studied the predictive value of the standard EEG and EEG with sleep deprivation for seizure relapse in adult patients presenting with a first unprovoked seizure. EEGs were performed on 157 adult patients within the first 48 hours of the first seizure. Read More

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Pearls, perils, and pitfalls in the use of the electroencephalogram.

Omkar N Markand

Semin Neurol 2003 Mar;23(1):7-46

Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Despite advances in neuroimaging techniques over the past three decades that have helped in identifying structural lesions of the central nervous system, electroencephalography (EEG) continues to provide valuable insight into brain function by demonstrating focal or diffuse background abnormalities and epileptiform abnormalities. It is an extremely valuable test in patients suspected of epilepsy and in patients with altered mental status and coma. Patterns in the EEG make it possible to clarify the seizure type; it is indispensable for the diagnosis of nonconvulsive status epilepticus and for separating epileptic from other paroxysmal (nonepileptic) episodes. Read More

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Neurophysiology of Rett syndrome.

Daniel G Glaze

Ment Retard Dev Disabil Res Rev 2002 ;8(2):66-71

Departments of Pediatrics and Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.

Neurophysiological evaluations have been widely applied in the study of Rett syndrome (RS) to provide information concerning the developmental aspects of RS; the character and extent of involvement of the central, peripheral, and autonomic nervous system pathways; and evaluation of the clinical symptomatology of RS. The electroencephalogram (EEG) is invariably abnormal and shows characteristic, though not diagnostic, changes: loss of expected developmental features; the appearance of focal, multifocal, and generalized epileptiform abnormalities; and the occurrence of rhythmic slow (theta) activity primarily in the frontal-central regions. Epileptic seizures are reported to occur frequently in RS, and partial and generalized seizures may be experienced by RS girls. Read More

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September 2002

Nondominant hemisphere lesions and conversion nonepileptic seizures.

J Neuropsychiatry Clin Neurosci 2001 ;13(3):367-73

Department of Neurology, New York University School of Medicine, NY 10016, USA.

To explore the hypothesis that lateralized hemispheric dysfunction may contribute to the development of conversion symptoms, the authors studied frequency of unilateral cerebral physiological or structural abnormalities in 79 consecutive patients with conversion nonepileptic seizures (C-NES), who were also compared with two groups of epilepsy patients without C-NES. Sixty (76%) of the C-NES patients had unilateral cerebral abnormalities on neuroimaging, of which 85% were structural. Ictal or interictal epileptiform abnormalities on EEG were found in 78% of C-NES patients and focal slowing in another 10%. Read More

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Stimulant therapy and seizure risk in children with ADHD.

Pediatr Neurol 2001 Feb;24(2):99-102

Department of Pediatrics, Division of Neurology, Evanston Hospital, IL 60201, USA.

Stimulants are an effective treatment frequently prescribed for attention-deficit-hyperactivity disorder (ADHD), but they commonly are believed to lower the threshold for seizures. Although several studies have revealed that stimulants do not exacerbate well-controlled epilepsy, there is a paucity of data about seizure risk in nonepileptic children treated with stimulants. Two hundred thirty-four children (179 males, 9. Read More

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February 2001

Brain plasticity and cellular mechanisms of epileptogenesis in human and experimental cortical dysplasia.

Epilepsia 2000 ;41 Suppl 6:S76-81

Department of Neurosciences, The Cleveland Clinic Foundation, Ohio 44195, USA.

Purpose: The cellular mechanisms that may contribute to epilepsy in resected human cortical dysplasia (CD) were compared with the in utero radiated rat CD model. In human and rat focal hippocampal epilepsy, postsynaptic N-methyl-D-aspartate receptors are up-regulated and presynaptic axon collaterals hyperinnervate them. We hypothesized that in both human and rat CD: (a) the N-methyl-D-aspartate receptor subunits NR1 and NR2A/B would be increased and coassembled, and (b) aberrant axons would be in regions of CD. Read More

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October 2000

Multimodality imaging for improved detection of epileptogenic foci in tuberous sclerosis complex.

Neurology 2000 May;54(10):1976-84

Department of Pediatrics, Children's Hospital of Michigan and Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI 48201, USA.

Objective: Using interictal alpha-[11C]methyl-l-tryptophan ([11C]AMT) PET scan, the authors have undertaken a quantitative analysis of all tubers visible on MRI or 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) PET, to determine the relationship between [11C]AMT uptake and epileptic activity on EEG.

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant disorder, often associated with cortical tubers and intractable epilepsy. The authors have shown previously that [11C]AMT PET scans show high tracer uptake in some epileptogenic tubers and low uptake in the remaining tubers. Read More

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NMDA-receptors 1 and 2A/B coassembly increased in human epileptic focal cortical dysplasia.

Epilepsia 1999 Dec;40(12):1683-7

Department of Neurosciences, The Cleveland Clinic Foundation, Ohio 44195, USA.

Purpose: This study was designed to quantify the relation between expressions of NMDA receptor (NMDAR) subunits (1 and 2A/B) and the epileptogenicity in human focal cortical dysplasia.

Methods: Immunoblotting and immunoprecipitation were used to quantify these receptor subunits in tissue resected from EEG-verified epileptic and distal nonepileptic frontal cortical areas in each of three patients as determined by chronic subdural electrode recordings. In each patient, adjacent sections were immunostained to verify that the numbers of dysplastic neurons were greater in epileptic than in nonepileptic cortex. Read More

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December 1999

Alumina gel injections into the temporal lobe of rhesus monkeys cause complex partial seizures and morphological changes found in human temporal lobe epilepsy.

J Comp Neurol 1998 Nov;401(2):266-90

Department of Anatomy and Neurobiology, University of California, Irvine 92697, USA.

The goal of the present study was to determine whether alumina gel injections into temporal lobe structures cause complex partial seizures (CPS) and pathological changes observed in human temporal lobe epilepsy. Rhesus monkeys with alumina gel injections in the amygdala, perirhinal and entorhinal cortices, or Ammon's horn and dentate gyrus all initially displayed focal pathological electroencephalographic (EEG) slowing limited to the site of injection. After clinical seizures developed, they also displayed widespread pathological EEG slowing over both hemispheres, interictal and ictal epileptiform EEG abnormalities limited to the mesial-inferior temporal lobe on the side of injection, and different degrees of spread to other ipsilateral and contralateral structures. Read More

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November 1998

Intracerebral recordings: organization of the human epileptogenic region.

J Engel

J Clin Neurophysiol 1993 Jan;10(1):90-8

Department of Neurology, UCLA School of Medicine.

Intracranial recordings from patients with medically refractory partial epilepsy have demonstrated that the concept of a discrete epileptic focus, as derived from experiments with animals, does not exist in this human condition. Furthermore, an EEG spike focus, as defined by electroencephalographers, does not faithfully identify the site of ictal onset. Rather, the boundaries of an epileptogenic region, which is necessary and sufficient for generation of habitual spontaneous seizures, must be approximated by knowledge of the spatial distribution of interictal spike discharges, and ictal onset, as well as the location of an epileptogenic lesion demonstrated by structural imaging, and the location and extent of nonepileptic focal functional deficits. Read More

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January 1993

The electroencephalogram in patients with epilepsy.

B F Westmoreland

Neurol Clin 1985 Aug;3(3):599-613

The EEG is useful in evaluating seizure disorders by establishing or confirming the diagnosis of a seizure disorder, determining the type and focus of origin of the seizure, and helping make the distinction between an epileptic attack and a nonepileptic condition. The EEG also may show other abnormalities, such as focal slowing, that give a clue about the underlying disease process. A negative EEG does not exclude the diagnosis of epilepsy. Read More

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