EEG Abnormalities In Patients Research Articles

EEG abnormalities in patients with PNES (P1-1.003)

<h3>Objective:</h3> Our goal is to characterize EEG abnormalities in patients with psychogenic non epileptic seizures (PNES) with and without epilepsy as well as examine the relationship between EEG and imaging in this cohort at a Level-4 Epilepsy center. <h3>Background:</h3> Prior studies have shown that <i>PNES patients have higher rates of EEG abnormalities; both epileptiform and non-epileptiform as compared to the general population. Studies have noted EEG changes in patients with PNES. For most of these studies, studying EEG abnormalities were not a primary goal. These studies were older, had smaller sample sizes, some were in specific groups (children, neurological conditions, developmentally delayed people ) or did not distinguish between underlying cerebral disorders vs or epilepsy. In one recent larger study, which did find higher rate of interictal EEG abnormalities in patients with PNES (1.8 times more likely, this did not reach significance) but used routine EEGs to study interictal data.</i> <h3>Design/Methods:</h3> Retrospective chart review of all patients discharged from the Epilepsy Monitoring Unit between 1/2016 and 12/2018. <h3>Results:</h3> 287 patients with PNES and 17 with PNES and epilepsy (PNES+E) were included. Age was mean of 41 years (PNES) and 39 years (PNES+E). 78.4% of PNES patients had normal interictal EEG, 21.6% had abnormal interictal EEG. 17.6% of PNES+E patients had normal interictal EEG and 82.4% had abnormal interictal EEG. Overall, 15.1 % of patients had an interictal epileptiform abnormality. 10.8% of pts with PNES had epileptiform discharges as compared to 88.2% of patients with PNES+E. Overall, 17.4% of the total pts had a non-epileptiform abnormality on their EEG. In the PNES group, this was 16% and in the PNES+E group, it was 41.2% <h3>Conclusions:</h3> Patients with PNES have a much higher rate of epileptiform discharges at 11% compared to the general population (~2%) <b>Disclosure:</b> Dr. Mirza has nothing to disclose. Dr. Agostini has nothing to disclose. The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS. Dr. Doyle has nothing to disclose. Dr. Alick-Lindstrom has nothing to disclose. irina podkorytova has nothing to disclose. Dr. Hays has nothing to disclose. Dr. Zepeda Garcia has nothing to disclose. Dr. Perven has nothing to disclose. Dr. Dieppa has nothing to disclose. Dr. Das has received personal compensation for serving as an employee of Concentra. Dr. Das has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for janicek. The institution of an immediate family member of Dr. Das has received research support from NIH.

EEG Findings in a Pediatric Patient with 3q29 Microdeletion Syndrome (P13-1.005)

<h3>Objective:</h3> 3q29 microdeletion syndrome is a rare genetic disorder which results from interstitial microdeletion of a segment on the long arm of chromosome 3. The syndrome is characterized by neurodevelopmental and psychiatric manifestations including intellectual disability, autism spectrum disorder, anxiety, executive function deficits, and psychosis/schizophrenia. Systemic manifestations include ocular issues, gastrointestinal disorders, dental anomalies, and congenital heart defects. <h3>Background:</h3> We present a 7-year-old boy with a history of intellectual disability including delayed speech and fine motor abilities, and autism spectrum disorder, who presented with frequent and new onset of complete behavioral arrest, staring, grunting and pulling movements lasting several minutes that were described by his teachers. Spells did not progress to tonic-clonic activity and were not associated with urine loss. His physical examination revealed down slanted eyes, epicanthal folds, wide mouth, long and thin philtrum, thin upper lip and axial and appendulicar tone were decreased. EEG while off ASM revealed excessive beta activity of the background, frontally dominant generalized spike/polyspike and wave discharges, and focal spike/polyspike and wave activity seen independently over the left and right frontocentral regions. MRI showed reduced cerebral white matter hemispheric volume involving the frontoparietal lobes with no obvious seizure focus. He was subsequently started on levetiracetam, which resulted in a cessation of staring spells. <h3>Design/Methods:</h3> NA <h3>Results:</h3> NA <h3>Conclusions:</h3> Seizures have been reported in 13% of patients with 3q29 microdeletion syndrome and are generally mild and responsive to ASM. Previously reported EEG abnormalities in patients with 3q29 microdeletion syndrome include focal epileptiform discharges in the left occipital region and slow waves in the frontotemporal regions. To our knowledge, generalized spike/polyspike wave activity has not previously been reported in this syndrome. Whether the independent focal frontocentral epileptiform discharges represent a forme fruste of the generalized discharges, or the latter represent a rapid secondary bisynchrony phenomenon, remains to be determined. <b>Disclosure:</b> Dr. Sheikh has nothing to disclose. Dr. Nascimento has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zogenix. The institution of Dr. Nascimento has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biocodex. Dr. Nascimento has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Nascimento has received research support from Zogenix. The institution of Dr. Nascimento has received research support from Biocodex. The institution of Dr. Nascimento has received research support from Greenwich. Dr. Nascimento has received publishing royalties from a publication relating to health care. Dr. Nascimento has a non-compensated relationship as a Editorial Team Member with Neurology RFS that is relevant to AAN interests or activities. Dr. Nascimento has a non-compensated relationship as a Production Team with Neurology Podcast that is relevant to AAN interests or activities. Dr. Waite has nothing to disclose. Dr. Lam has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage Therapeutics. Dr. Lam has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurona Therapeutics. Dr. Lam has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cognito Therapeutics. The institution of Dr. Lam has received research support from Sage Therapeutics.

A practical value of systematic reviews and meta-analyses on prevalence of EEG abnormalities in COVID-19

During the COVID-19 pandemics, the amount and volume of electroencephalographic (EEG) examinations have been limited for safety reasons. This has complicated not only an identification of specific EEG correlates of the disease but also an assessment of non-specific EEG changes in pa- tients with COVID-19, raising the question of detection of factors and the degree of their impact on prevalence of EEG abnormalities in COVID-19. In the PubMed database, three meta-analyses and three systematic reviews were selected on keywords “COVID-19”, “EEG”, “systematic review”, and “meta-analysis” in order to compare values of the prevalence of EEG abnormalities in patients with COVID-19. The systematic reviews and meta-analyses, which had been performed since 2020 and assessed the prevalence of EEG abnormalities in patients with COVID-19, had differences in their final results despite of an application of the same mathematical methods, criteria for classification of phenomena, usage of one limited base of sources with EEG results (the percentage of overlapped outcome data in the selected reviews and meta-analyses ranged from 22 % to 100 %). Differences between works, which were included in this article, on qualitative and quantitative values of degree of brain functional activity changes in a part of patients with COVID-19 have a sufficiently random nature due to not only volumes of the samples, but also a number of other subjective and objec- tive factors. The results of the presented systematic reviews and meta-analyses suggest, that not all of the obtained EEG data might be extrapolated on a cohort of patients with COVID-19, as the vast majority of patients with COVID (from 85 % to 100 %) examined with EEG had non-specific EEG-changes of a various genesis. A detection of the prevalence of non-specific EEG abnormalities in COVID-19 could have practical implication, particularly for prognosis of outcomes, only on condition of EEG analysis in samples of patients united by a certain common criterion, such as age, presence of certain neurological symptom/syndrome, specific neurological pathology in their anamnesis, etc.

Neuronal Abnormalities Induced by an Intelligent Virtual Reality System for Methamphetamine Use Disorder.

Methamphetamine use disorder (MUD) is a brain disease that leads to altered regional neuronal activity. Virtual reality (VR) is used to induce the drug cue reactivity. Previous studies reported significant frequency-specific neuronal abnormalities in patients with MUD during VR induction of drug craving. However, whether those patients exhibit neuronal abnormalities after VR induction that could serve as the treatment target remains unclear. Here, we used an integrated VR system for inducing drug related changes and investigated the neuronal abnormalities after VR exposure in patients. Fifteen patients with MUD and ten healthy subjects were recruited and exposed to drug-related VR environments. Resting-state EEG were recorded for 5 minutes twice-before and after VR and transformed to obtain the frequency-specific data. Three self-reported scales for measurement of the anxiety levels and impulsivity of participants were obtained after VR task. Statistical tests and machine learning methods were employed to reveal the differences between patients and healthy subjects. The result showed that patients with MUD and healthy subjects significantly differed in Θ, α, and γ power changes after VR. These neuronal abnormalities in patients were associated with the self-reported behavioral scales, indicating impaired impulse control. Our findings of resting-state EEG abnormalities in patients with MUD after VR exposure have the translational value and can be used to develop the treatment strategies for methamphetamine use disorder.

EEG Abnormalities and Their Radiographic Correlates in a COVID-19 Inpatient Cohort.

To identify the prevalence of EEG abnormalities in patients with coronavirus disease 2019 (COVID-19) with neurologic changes, their associated neuroimaging abnormalities, and rates of mortality. A retrospective case series of 192 adult COVID-19-positive inpatients with EEG performed between March and June 2020 at 4 hospitals: 161 undergoing continuous, 24 routine, and 7 reduced montage EEG. Study indication, epilepsy history, intubation status, administration of sedatives or antiseizure medications (ASMs), metabolic abnormalities, neuroimaging pathology associated with epileptiform abnormalities, and in-hospital mortality were analyzed. EEG indications included encephalopathy (54.7%), seizure (18.2%), coma (17.2%), focal deficit (5.2%), and abnormal movements (4.6%). Epileptiform abnormalities occurred in 39.6% of patients: focal intermittent epileptiform discharges in 25.0%, lateralized periodic discharges in 6.3%, and generalized periodic discharges in 19.3%. Seizures were recorded in 8 patients, 3 with status epilepticus. ASM administration, epilepsy history, and older age were associated with epileptiform abnormalities. Only 26.3% of patients presented with any epileptiform abnormality, 37.5% with electrographic seizures, and 25.7% patients with clinical seizures had known epilepsy. Background findings included generalized slowing (88.5%), focal slowing (15.6%), burst suppression (3.6%), attenuation (3.1%), and normal EEG (3.1%). Neuroimaging pathology was identified in 67.1% of patients with epileptiform abnormalities, over two-thirds acute. In-hospital mortality was 39.5% for patients with epileptiform abnormalities and 36.2% for those without. Risk factors for mortality were coma and ventilator support at time of EEG. This article highlights the range of EEG abnormalities frequently associated with acute neuroimaging abnormalities in COVID-19. Mortality rates were high, particularly for patients in coma requiring mechanical ventilation. These findings may guide the prognosis and management of patients with COVID-19 and neurologic changes.

EEG abnormalities in patients with delirium as a predictive biomarker of dementia with Lewy bodies

Delirium is an acute neurological dysfunction, characterized by altered conscious state, akin to fluctuating cognition. It is frequent in elderly patients when hospitalized and is characterized by an increased risk of developing dementia, especially Dementia with Lewy Bodies (DLB). EEG Prominent posterior slow-wave activity in the pre-alpha/ theta range is a supportive biomarker for DLB diagnosis from the prodromal stage. This EEG pattern correlates with fluctuating cognition and is the electrophysiological underpinning of the so called thalamo-cortical dysrhythmia.

The Elecroencephalographic Study Findings in Patients with Migraine without Aura

Background: There are different EEG findings in patients with migraine without aura, but still the majority of patients have normal EEG recordings. Aim of the study: To evaluate EEG abnormalities in patients with migraine without aura. Methods: Thirty patients with common migraine are evaluated by EEG test. Age of patients rage from 18-45 years, eighteen of them was females and twelve were males. EEG was performed during headache and as soon as possible after attacks of headache. Results: Out of the 30 patients who are studied, only 6(20%) show EEG changes, 4 females and 2 males, while the rest 24(80%) migraineurs had normal EEG. Of the 6 patients with EEG changes, 3 have left sided headache, 2 right sided headache and one bilateral headache. The EEG findings was slow waves in 4 patients (50%), sharp waves in 3 patients (37.5%), and spike in one patient (12.5%). The sites of EEG changes were 4 in frontal area, 3 in occipital area and 2 in temporal area. Bilateral EEG changes present in all 6 patients. Conclusion: Our study shows significant EEG abnormalities in a good proportion of patients with migraine without aura, but these findings are not specific and cannot replace clinical and neurologic diagnosis.

Study of electroencephalography in people with generalized epilepsy in a Saudi population

ABSTRACT Background Electroencephalography (EEG) remains a vital tool in the diagnostic evaluation of patients with epilepsy (GE), however, there is scarcity of information on the yield and potential clinical variables that are associated with EEG abnormalities in people with GE. Objective The study aimed to evaluate the yield and pattern of EEG abnormalities in patients with GE with the view to determining factors that are independently associated with abnormal EEG in them. Methods We characterized EEG features and evaluated associated factors in a sample of people with GE in a Saudi population. Standard definition of interictal epileptiform discharges was used. Results A total of 1105 (77%) out of 1436 GE patients had EEG. Five hundred and ninety-five (53.85%) patients had abnormal EEG. Factors associated with EEG abnormalities before adjustment for confounders were age, gender, duration of epilepsy, and seizure frequency. However, only frequency of seizure (P = 0.0018), gender (P < 0.0001), and age (P < 0.0001) were independently associated with EEG abnormalities. Conclusion The study showed a modest yield (54%) of abnormal EEG in the cohort of patients with GE. Frequency of seizure, age, and gender, independently predicted the presence of EEG abnormality in people living with GE.

EEG abnormalities in patients with chronic neuronopathic Gaucher disease: A retrospective review

The clinical phenotype of Gaucher disease type 3 (GD3), a neuronopathic lysosomal storage disorder, encompasses a wide array of neurological manifestations including neuro-ophthalmological findings, developmental delay, and seizures including progressive myoclonic epilepsy. Electroencephalography (EEG) is a widely available tool used to identify abnormalities in cerebral function, as well as epileptiform abnormalities indicating an increased risk of seizures. We characterized the EEG findings in GD3, reviewing 67 patients with 293 EEGs collected over nearly 50 years. Over 93% of patients had some form of EEG abnormality, most consisting of background slowing (90%), followed by interictal epileptiform discharges (IEDs) (54%), and photoparoxysmal responses (25%). The seven patients without background slowing were all under age 14 (mean 6.7 years). There was a history of seizures in 37% of this cohort; only 30% of these had IEDs on EEG. Conversely, only 56% of patients with IEDs had a history of seizures. These observed EEG abnormalities document an important aspect of the natural history of GD3 and could potentially assist in identifying neurological involvement in a patient with subtle clinical findings. Additionally, this comprehensive description of longitudinal EEG data provides essential baseline data for understanding central nervous system involvement in neuronopathic GD.

Status epilepticus and other EEG findings in patients with COVID-19: A case series

PurposeNeurological manifestations of COVID-19 infection include impaired consciousness, strokes, and seizures. Limited reports describing EEG abnormalities in patients with COVID-19 have been published. These articles reported nonspecific encephalopathic patterns, epileptiform discharges, and rarely seizures. Our primary aim was to assess EEG abnormalities in patients with COVID-19 and evaluate for epileptiform activity or seizures. MethodsWe identified five critically ill adult patients with COVID-19 who underwent EEG monitoring. All patients had Ceribell™ rapid response EEG initially and two continued with conventional long-term video EEG. ResultsAll 5 patients had encephalopathy and 3 also had seizure-like movements, thus prompting EEG monitoring. EEGs all showed nonspecific markers of encephalopathy including diffuse slowing and generalized rhythmic delta activity. Two also had epileptiform discharges reaching 2−3 Hz at times, with one patient in nonconvulsive status epilepticus and the other developing clinical status epilepticus with myoclonic movements. EEG and clinical symptoms improved with anti-seizure medications. ConclusionStatus epilepticus was present in 2 out of our cohort of 5 critically ill patients who underwent EEG monitoring. These findings highlight the importance of EEG monitoring in high-risk patients with COVID-19 and encephalopathy. EEG recordings in such patients can identify pathological patterns that will benefit from treatment with anti-seizure medications.

EEG Abnormalities in Patients with Suspected Encephalopathy Receiving Cefepime vs Piperacillin-Tazobactam (1712)

EEG Abnormalities in Patients with Suspected Encephalopathy Receiving Cefepime vs Piperacillin-Tazobactam (1712)

P40-T EEG characteristics in Polish patients with Unverricht-Lundborg disease

Background Unverricht-Lundborg disease (ULD) is an autosomal recessive form of progressive myoclonus epilepsy with a wide range of neurologic and psychiatric symptoms including tonic-clonic seizures, myoclonus, ataxia, tremor, dysarthria, depression, and mild intellectual decline. The aim of the study was to describe the EEG features of patients with ULD and their changes during the long-term follow-up. Material and methods We retrospectively evaluated the EEG features of 11 patients with genetically confirmed ULD. Results We included 4 females and 7 males with the mean age 38.3 ± 7.6 years and the mean age at onset 9.4 years. The average background rhythm was 8.4 Hz and was normal in 2 patients and slightly slowed in 9. Spike and wave discharges (SWD) were found in 9 patients and photosensitivity in 2 patients. In all patients myoclonic jerks were recorded in videoEEG, most of the myoclonic movements were not time-locked to epileptiform discharges. In 3 patients SWD and myoclonic jerks were aggravated by ill -advised antiepileptic drugs (phenytoin and carbamazepine) and their frequency diminished after treatment change. Despite the increased frequency and severity of myoclonic jerks the frequency of SWD decreased gradually with time. Conclusion The most common EEG abnormalities in patients with ULD include background slowing and spike and wave discharges; epileptiform discharges can be aggravated by ill-advised antiepileptic drugs.

EEG Abnormalities as a Neurophysiological Biomarker of Severity in Autism Spectrum Disorder: A Pilot Cohort Study.

To date, the phenotypic significance of EEG abnormalities in patients with ASD is unclear. In a population affected by ASD we aimed to evaluate: the phenotypic characteristics; the prevalence of EEG abnormalities; the potential correlations between EEG abnormalities and behavioral and cognitive variables. Sixty-nine patients with ASD underwent cognitive or developmental testing, language assessment, and adaptive behavior skills evaluation as well as sleep/wake EEG recording. EEG abnormalities were found in 39.13% of patients. EEG abnormalities correlated with autism severity, hyperactivity, anger outbursts, aggression, negative or destructive behavior, motor stereotypies, intellectual disability, language impairment and self-harm. Our findings confirmed that EEG abnormalities are present in the ASD population and correlate with several associated phenotypic features.

Seizure-like episodes and EEG abnormalities in patients with long QT syndrome

PurposeThe congenital long QT-syndrome (cLQTS) is characterized by ventricular arrhythmias, syncope and sudden cardiac death. Many LQTS genes are also expressed in the brain and emerging evidence suggest that cardiac channelopathies can also cause epilepsy. The aim of the study is to explore evidence of epilepsy and/or EEG abnormalities in a cohort with a genotyped diagnosis of LQT1 or LQT2. MethodsAdult patients were randomly selected from the outpatient clinic and a random sample of healthy controls were recruited from the general population. Ictal semiology was explored in symptomatic patients. A 1 h 64-channel awake EEG was performed and analyzed by visual assessment. Brain connectivity was quantified by Directed Transfer Function (DTF) from the current source density estimate within the theta band (4–7 Hz). ResultsFifteen patients with LQT1, 20 with LQT2 and 20 controls were included. Seventy-one % of the patients reported loss of consciousness (LOC); 44% in combination with convulsions. EEG was abnormal in 34% of patients and 10% of controls (p < 0.05). Two patients had epileptiform or sharp activity. The fronto-parietal DTF connectivity was significantly altered in patients compared to controls (LQT1 p = 2.2 × 10−6, LQT2 p = 0.044). ConclusionSeizure-like episodes and EEG abnormalities were common in our cohort with cLQTS patients. However, we could not find firm evidence of epilepsy.Our findings reinforce the notion that cLQTS is a cardiocerebral channelopathy. Correct classification of seizures may be challenging to the clinician, but of vital importance for patients.

The effects of risk factors on EEG and seizure in children with ADHD.

Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly seen developmental disorders in childhood. Its etiology, however, is not well known even though bio-psycho-social reasons have been thought to play a big role. The aims of this retrospective study are to identify the risk factors of ADHD in patients diagnosed with ADHD in childhood, analyze the relationship between clinical symptoms and risk factors to which they were exposed and determine their effects on prospective electrophysiological findings. Longitudinal cohort study of all children with ADHD treated at Ankara University Medical University during 2007-2012, with follow-up to ascertain risk factors and seizure and EEG abnormalities outcome. Multinominal univariate logistic regression analysis was used to calculate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for associations. Epileptiform discharges were found in 32 (22.9%) of the 140 ADHD patients. Of these, 71.9% had focal epileptiform discharges and 28.1% had generalized epileptiform discharges. The focal epileptiform discharges were most prevalent from the rolandic area. Among the 140 patients, 20 (14.3%) had a previous history of seizure, and all twenty had epileptiform discharges on EEG whereas none of the patients who had normal EEG had a seizure history. The rates of epileptiform discharges were significantly related to gestational age and asphyxia (RR: 1.8, 95% CI 0.3, 9.3; RR: 9.6, 95% CI 2.3, 40, respectively), whereas the rates of epilepsy were related to asphyxia but not gestational age. History of asphyxia and prematurity do seem to increase the risk of EEG abnormality in patients with ADHD. Modification of these environmental risk factors by evidence-based prevention programs may help to decrease the burden of ADHD.

EEG Abnormalities as Diagnostic and Prognostic Factor for Encephalitis

Abstract The aim of the study is to examine whether EEG abnormalities in patients with encephalitis might be prognostic and diagnostic factors for final epilepsy outcome and/or be correlated with the severity of the disability. The most frequent causes of encephalitis were HSV, WNV, INF V, MTB, St PN, St AU. There was a highly statistically significant positive correlation between the severity of the EEG abnormalities at the beginning of the disease (r = 0.410, p &lt;0.01) and the ultimate outcome. Electroencephalography in the early stages of encephalitis shows diagnostic and prognostic significance and, in combination with the overall severity of the clinical picture, could contribute to the diagnosis and assessment of outcomes and, ultimately, the correction of treatment and faster recovery of patients. This is particularly true for viral encephalitis.

Electroencephalographic Findings in Children with Attention Deficit Hyperactivity Disorder

Objective: The relationship between cognitive functions, EEG findings and epilepsy in patiens with ADHD is controversial. The aim of this study is to determine the frequency of EEG abnormality and its relationship with clinical findings of children with ADHD. Methods: A total of 434 children’s sleep and/or awake EEG who received the diagnosis of ADHD were taken regardless of seizure history. Results: A total of 21.9% epileptic and 15.2% nonepileptic discharges were detected in EEG. Epileptic discharges were found to bemore common in the attention deficit type of ADHD, in right hemisphere regions and were significantly higher in patients who had sleep EEG compared to those who had awake EEG (p<0.0001). Conclusion: The presence of EEG abnormalities in patients with ADHD is associated with clinical findings. Interictal epileptic discharges could affect cognitive functions. EEG recordings including sleep should be taken even in the absence of seizure history.

Daytime sleepiness and EEG abnormalities in patients treated with second generation antipsychotic agents

BackgroundThe aim of this study was to verify whether or not an increased prevalence of excessive daytime sleepiness (EDS) or EEG abnormalities is observed in patients with schizophrenia spectrum disorders (SSD), and to compare the effects of second generation antipsychotics (SGA) on patients’ daytime sleepiness level and EEG recordings. MethodsEEG recordings and self-reports of EDS, assessed with Epworth (ESS) and Stanford (SSS) Sleepiness Scales, were compared between 244 patients with SSD and 82 patients with anxiety, personality or behavioral disorders (non-psychotic disorders, NPD). To examine the effects of various SGA, patients treated in monotherapy with aripiprazole, olanzapine, clozapine, risperidone and sertindole were compared. ResultsA higher prevalence of abnormal EEG recordings was observed in SSD patients. No significant differences in average daytime sleepiness were found between patients with SSD and NPD; however, patients with SSD had longer sleep duration. Aripiprazole treatment was associated with significantly smaller and less frequent EEG abnormalities than treatment with any other SGA, while treatment with clozapine and olanzapine was related to an increased prevalence of severe EEG abnormalities. Patients with SSD treated with SGA in monotherapy were less sleepy than unmedicated patients with NPD. ConclusionsAlthough antipsychotics may have profound effects on EEG patients with schizophrenia do not have higher daytime sleepiness than patients with anxiety/personality disorders. Patients with schizophrenia may compensate sedative effects of antipsychotic treatment with sleep duration prolongation and report even less sleepiness than non-psychotic patients.

Left dominance of EEG abnormalities in patients with transient global amnesia

PurposeTransient global amnesia (TGA) is a syndrome of unknown etiology. Electroencephalographic (EEG) abnormalities in TGA have been reported previously. We analyzed the frequency and characteristics of EEG abnormalities in patients with TGA. MethodsWe collected EEGs of patients with a clinical diagnosis of TGA who had visited the emergency room or the outpatient clinic over a period of 8 years and compared clinical and demographic characteristics of the patients with normal EEGs with those with abnormal EEGs. ResultsEEG abnormalities were found in 35 (22.9%) out of 153 patients and epileptiform discharges were seen in 26 (74.3%) out of these 35 patients. Spikes or sharp waves were detected on the left side only (48.6%) or on both sides (25.7%), but none of the patients showed spikes or sharp waves on right side only. In six patients the EEG had normalized within three months of presentation, in ten within six months, and in twelve by one year. The EEG remained abnormal in eleven out of the 23 patients one year after presentation. ConclusionIn this largest consecutive EEG study at one center, the proportion of patients with TGA in whom epileptiform discharges were demonstrated within days of the episode of TGA was significantly higher than in the previous literature. EEG abnormalities such as spikes or sharp waves spontaneously disappeared in almost half of cases over one-year of follow-up. There was a clear left dominance of EEG abnormalities in patients with TGA.

Does sleep deprivation alter functional EEG networks in children with focal epilepsy?

Electroencephalography (EEG) recordings after sleep deprivation increase the diagnostic yield in patients suspected of epilepsy if the routine EEG remains inconclusive. Sleep deprivation is associated with increased interictal EEG abnormalities in patients with epilepsy, but the exact mechanism is unknown. In this feasibility study, we used a network analytical approach to provide novel insights into this clinical observation. The aim was to characterize the effect of sleep deprivation on the interictal functional network organization using a unique dataset of paired routine and sleep deprivation recordings in patients and controls. We included 21 children referred to the first seizure clinic of our center with suspected new onset focal epilepsy in whom a routine interictal and a sleep deprivation EEG (SD-EEG) were performed. Seventeen children, in whom the diagnosis of epilepsy was excluded, served as controls. For both time points weighted functional networks were constructed based on interictal artifact free time-series. Routine and sleep deprivation networks were characterized at different frequency bands using minimum spanning tree (MST) measures (leaf number and diameter) and classical measures of integration (path length) and segregation (clustering coefficient). A significant interaction was found for leaf number and diameter between patients and controls after sleep deprivation: patients showed a shift toward a more path-like MST network whereas controls showed a shift toward a more star-like MST network. This shift in network organization after sleep deprivation in patients is in accordance with previous studies showing a more regular network organization in the ictal state and might relate to the increased epileptiform abnormalities found in patients after sleep deprivation. Larger studies are needed to verify these results. Finally, MST measures were more sensitive in detecting network changes as compared to the classical measures of integration and segregation.