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. 2015 Aug 4;85(5):471-8.
doi: 10.1212/WNL.0000000000001805. Epub 2015 Jul 2.

A practical, simple, and useful method of categorizing interictal EEG features in children

Se Hee Kim  1 , Christian M Korff  1 , Andrew J Kim  1 , Douglas R Nordli Jr  2
Affiliations

A practical, simple, and useful method of categorizing interictal EEG features in children

Se Hee Kim et al. Neurology. .

Abstract

We introduce a simple scheme of categorizing interictal EEG in patients with pediatric epilepsy. Five patterns of EEG can be determined by using 2 interictal EEG domains: organization of the background activity and a morphology/topography of epileptiform discharges. These patterns relate to commonly recognized categories of pediatric epilepsy: familial epilepsies, genetic generalized epilepsies, self-limited epilepsies, epilepsies with encephalopathy, and focal structural epilepsies. Each group has distinguishable clinical presentations, inheritance patterns, and outcomes. This categorization may be a useful educational tool; it may also guide decisions about further testing and management.

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Figures

Figure 1
Figure 1. EEG patterns 2 and 3
The background is normal and interictal epileptiform discharges are stereotyped. (A) EEG pattern 2. A normal background and stereotyped generalized synchronous spike-waves with frontal accentuation are observed. (B) EEG pattern 3. EEG shows highly stereotyped spike-wave complexes localized in the occipital region. Background EEG is normal.
Figure 2
Figure 2. EEG patterns 4a and 5b
(A) In EEG pattern 4a, the background is diffusely slowed and interictal epileptiform discharges are pleomorphic and multifocal. (B) In EEG pattern 5b, the background is markedly asymmetric. Interictal epileptic discharges are pleomorphic and multifocal, predominant on the right hemisphere. The background activity is frequently interrupted by marked electrodecrements.
Figure 3
Figure 3. Genetics, clinical outcome, and epilepsy syndrome examples of each EEG pattern group
AD = autosomal dominant; EFMR = epilepsy and mental retardation restricted to females; EIEE = early infantile epileptic encephalopathy; EME = early myoclonic encephalopathy; GTC = generalized tonic-clonic seizure.
See this image and copyright information in PMC

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