Classification of electrical status epilepticus in sleep based on EEG patterns and spatiotemporal mapping of spikes

• DOI: 10.1684/epd.2022.1486
• Publication Date: 2022-09-20T14:00:13Z
• Authors: Neetha Balaram; James Jose; Abdul V. Gafoor; Smita Balachandran
• Keywords: Sulcus

We firstly aimed to describe and classify EEG patterns in electrical status epilepticus sleep (ESES), secondly subclassify based on analysis of spikes using spatio-temporal mapping source analysis.Overnight EEGs (minimum: eight hours) 30 children, aged 2-12 years, with ESES (spike-wave index: at least 50%) were selected. Average reference montage was used for dipole mapping. The location orientation the dipoles determined by positive negative poles applying rules onset propagation latency between two hemispheres (for bisynchronous spikes) (based BESA research 7.1).(1) classified as “generalised” (80%) focal (20%) patterns; (2) subtype pattern due apparently synchronous bilateral activation (with lead-in 20-60 ms from one hemisphere) a tangential/oblique (source localised these around peri-rolandic cortex); (3) classic description “diffuse” bifrontal maxima is misinterpretation 10-20 system .Using voltage analysis, cortical rolandic cortex identified which imparts diffuse frontal negativity parieto-occipital positivity; (4) showed intraspike interspike instability changed local spike into depth sulcus (which we refer herein “dancing dipoles”); (5) parietal, occipital temporo-occipital patterns;a not seen.Based detailed ESES, have successfully reinterpreted various misconceptions literature. simplified interpretation complicated extracting primary propagated sources aid classification ESES. As always stable self-limited childhood epilepsy centrotemporal spikes, believe that phenomenon an intrinsically unstable reliable qualitative marker