Abstract
We aimed to analyse the ictal electrographic changes on scalp electroencephalography (EEG), focusing on high-voltage slow waves (HVSs) in children with epileptic spasms (ES) and tonic spasms (TS) and then identified factors associated with corpus callosotomy (CC) outcomes. We enrolled 17 patients with ES/TS who underwent CC before 20 years of age. Post-CC Engel’s classification was as follows: I in 7 patients, II in 2, III in 4, and IV in 4. Welch’s t-test was used to analyse the correlation between ictal HVSs and CC outcomes based on the following three symmetrical indices: (1) negative peak delay: interhemispheric delay between negative peaks; (2) amplitude ratio: interhemispheric ratio of amplitude values for the highest positive peaks; and (3) duration ratio: interhemispheric ratio of slow wave duration. Ages at CC ranged from 17–237 months. Four to 15 ictal EEGs were analysed for each patient. The negative peak delay, amplitude ratio and duration ratio ranged from 0–530 ms, 1.00–7.40 and 1.00–2.74, respectively. The negative peak delay, amplitude ratio and duration ratio were significantly higher in the seizure residual group (p = 0.017, <0.001, <0.001, respectively). Symmetry of ictal HVSs may predict favourable outcomes following CC for ES/TS.
Highlights
We aimed to analyse the ictal electrographic changes on scalp electroencephalography (EEG), focusing on high-voltage slow waves (HVSs) in children with epileptic spasms (ES) and tonic spasms (TS) and identified factors associated with corpus callosotomy (CC) outcomes
We investigated the correlations between the symmetry indices of ictal HVSs and CC outcomes in patients with ES/TS
Our findings revealed that asymmetry of ictal HVSs in ES/TS is correlated with insufficient efficacy of CC for seizures
Summary
We aimed to analyse the ictal electrographic changes on scalp electroencephalography (EEG), focusing on high-voltage slow waves (HVSs) in children with epileptic spasms (ES) and tonic spasms (TS) and identified factors associated with corpus callosotomy (CC) outcomes. Welch’s t-test was used to analyse the correlation between ictal HVSs and CC outcomes based on the following three symmetrical indices: (1) negative peak delay: interhemispheric delay between negative peaks; (2) amplitude ratio: interhemispheric ratio of amplitude values for the highest positive peaks; and (3) duration ratio: interhemispheric ratio of slow wave duration. Previous studies have identified three contiguous patterns of ictal electroencephalography (EEG) findings during spasms: (1) fast waves or high-frequency oscillations (HFOs) preceding the ES, (2) high-voltage slow waves (HVSs) and (3) desynchronization[3,4,5]. West syndrome Symptomatic generalised epilepsy Aetiology Structural abnormality Genetic/chromosomal syndrome Unknown Age at epilepsy onset [months, range (mean)] Total number of AEDs before CC [range (mean)] Frequency of ES/TS 1–20/day >20/day
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