Multiple Spike Foci Research Articles

Psychomotor epilepsy and psychosis

The EEG findings in waking, sleep, and sphenoidal electrode recordings in 96 patients with partial epileptic seizures with complex symptoms, who, after a median interval of 18 years developed paranoid/hallucinatory psychosis, were compared with the findings from a group of patients without psychosis, who had had the same type of epilepsy in median 24 years. There were no significant differences between the two groups with regard to median age at onset of epilepsy or complex partial seizures, age, or duration of epilepsy at time of examination. The psychotic patients had a significant preponderance of temporal medio-basal spike foci, recorded on the sphenoidal electrode, indicating deep temporal lobe dysfunction as an important factor in the pathogenesis of psychosis. A significant higher frequency of bilateral and multiple spike foci, together with a significant frequency of slow-wave admixture to the waking background EEG activity, indicated more extensive and severe epileptogenic lesions in the psychotic patients. There was no correlation between psychosis and unilateral EEG-foci in either temporal lobe.

The Benign Partial Nonrolandic Epilepsies

Although rolandic epilepsy is the only epileptic syndrome that, at present, fully meets all the criteria of benignity and is widely recognized as such, there are also other forms of partial epilepsy that are benign. These are also genetically determined and age-dependent, occurring in neurologically intact children older than 18 months of age. As a rule, the seizures are brief and infrequent, usually responding well to antiepileptic drugs and remitting spontaneously before adulthood. The EEG background is normal, the morphology of the spikes is typical, and they are activated by sleep; generalized spike-wave discharges may occur. During the past decade, there have been reports of a number of additional syndromes of benign partial epilepsy. These include benign occipital epilepsy (the most common in this group), benign frontal epilepsy, benign epilepsy with affective symptomatology (or benign psychomotor epilepsy), benign epilepsy with extreme somatosensory evoked potentials, benign partial epilepsy of adolescence, and benign epilepsy associated with multiple spike foci. The Landau-Kleffner syndrome is often included among the benign epilepsies. These nonrolandic benign epilepsies are described in detail, and the relevant literature is reviewed.

Functional alteration of deep structures in cats with chronic focal cortical irritative lesions.

Introduction The significance of independent paroxysmal abnormalities 2,17,24,45 or multiple spike foci 27,46 in deep cerebral structures of some epileptics has not been clearly understood. The latter finding and relatively low cure percentage in his own series of surgical epileptic cases led Meyers to challenge seriously the conceptual basis of current day epilepsy surgery. 28 Although the Montreal school 32 reported a higher percentage of satisfactory results in a larger and carefully selected focal epilepsy population, the importance of further careful analysis of failure cases in surgery for epilepsy can not be overemphasized. Possible reasons for surgical failure may be (1) incomplete excision of the cortical focus or (2) location of the original focus in the depth rather than on the surface. Such possibilities have received substantial support from both clinical and experimental studies. A further possibility is that an independent secondary deep abnormality might be produced by long-standing bombardment