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Clinical and Electroencephalographic Evidence for Sites of Origin of Seizures with Diffuse Electrodecremental Pattern
Author(s) -
Arroyo Santiago,
Lesser Ronald P.,
Fisher Robert S.,
Vining Eileen P.,
Krauss Gregory L.,
BandeenRoche Karen,
Hart John,
Gordon Barry,
Uematsu Sumio,
Webber Robert
Publication year - 1994
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1994.tb02542.x
Subject(s) - ictal , electroencephalography , epilepsy , frontal lobe , temporal lobe , psychology , complex partial seizures , neuroscience , anesthesia , tonic (physiology) , central nervous system disease , medicine
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.