Changes in Interictal Pretreatment and Posttreatment EEG in Childhood Absence Epilepsy.

Pawel Glaba,Marta Kuryło,Miroslaw Latka,Małgorzata J Krause,Wojciech Jernajczyk,Bruce J West,Wojciech Walas

doi:10.3389/fnins.2020.00196

Abstract

Spike and wave discharges (SWDs) are a characteristic manifestation of childhood absence epilepsy (CAE). It has long been believed that they unpredictably emerge from otherwise almost normal interictal EEG. Herein, we demonstrate that pretreatment closed-eyes theta and beta EEG wavelet powers of CAE patients (20 girls and 10 boys, mean age 7.4 ± 1.9 years) are much higher than those of age-matched healthy controls at multiple sites of the 10–20 system. For example, at the C4 site, we observed a 100 and 63% increase in power of theta and beta rhythms, respectively. We were able to compare the baseline and posttreatment wavelet power in 16 patients. Pharmacotherapy brought about a statistically significant decrease in delta and theta wavelet power in all the channels, e.g., for C4 the reduction was equal to 45% (delta) and 63% (theta). The less pronounced attenuation of posttreatment beta waves was observed in 13 channels (36% at C4 site). The beta and theta wavelet power were positively correlated with the percentage of time in seizure (defined as the ratio of the duration of all absences which patients experienced to the duration of recording) for majority of channels. We hypothesize that the increased theta and beta powers result from cortical hyperexcitability and propensity for epileptic spike generation, respectively. We argue that the distinct features of CAE wavelet power spectrum may be used to define an EEG biomarker which could be used for diagnosis and monitoring of patients.

Highlights

Childhood absence epilepsy (CAE) is the most common pediatric epileptic syndrome
The spectacular increase of beta wavelet power in the vicinity of the epileptic spikes in Figure 1B can be employed in the simple but highly effective spike and wave discharges (SWDs) detector which we describe elsewhere
GAERS and the WAG/Rij rodent models have paved the way for the understanding of pathophysiology of human childhood absence epilepsy (CAE) seizures (Akman et al, 2010)

Summary

Introduction

Childhood absence epilepsy (CAE) is the most common pediatric epileptic syndrome. It has a prevalence of 10–15% in childhood epilepsies and an incidence of 1.3–6 per 100,000 in children under the age of 16 years (Covanis, 2010). The ictal EEG of a typical absence seizure demonstrates rhythmic ∼3 Hz bilateral, synchronous and symmetrical spike and wave discharges (SWDs) with a median duration of approximately 10 s, which may appear several times per day, sometimes as often as dozens of times per day (Schomer and Lopes da Silva, 2018). Interictal EEG abnormalities include sparse fragments of SWDs and focal discharges as well as posterior bilateral delta activity (Sadleir et al, 2006)

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Results

Conclusion