It has been known that sleep and epilepsy have strong mutual influence and many reports have emphasized the imortance of the EEG recording during sleep in epileptic patients. We analyzed waking and sleep EEGs of 153 consecutive cases of epileptic patients. Waking and sleep recordings were perforrned in succession during 26 minutes. Sleep induction method was 24 to 26 hour sleep deprivation. Most of the sleep recordings consisted of stage 1 and stage 2 sleep. 134 patients had localization-related epilepsy including 23 cases of benign rolandic epilepsy and benign epilepsy with occipital paroxysms, and 19 patients had generalized epilepsy. Ninty-two cases showed definite epileptiform discharges and 37 patients including 30 cases of complex partial seizure disorder had all their epileptiform discharges detected only during sleep state. The epileptiforrn discharges of 43 patients were detected on both waking and sleep recordings and underwent modifications of focalization, synchronization, generalization and the appearance of independent spikes during sleep state.
Electroencephalography* ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Complex Partial ; Epilepsy, Generalized ; Epilepsy, Rolandic ; Generalization (Psychology) ; Humans ; Sleep Deprivation

BACKGROUND: Localizable scalp ictal EEG appears to be rare in neocortical epilepsy. However, there have not been many studies based upon a large number of patients. This study aims to identify the characteristic patterns of variable neocortical epilepsies and to evaluate their clinical usefulness in the localization of epileptogenic foci. METHODS: We retrospectively assessed 394 noninvasive ictal recordings from 86 patients who subsequently underwent invasive study and resective surgery. Ictal EEGs were recorded by video-EEG monitoring systems with electrodes placed according to the international 10-20 system including additional anterior temporal electrodes. Ictal recordings were analyzed accord-ing to the localizing accuracy and frequency characteristics. The durations of discrete or regional ictal rhythms were also measured. RESULTS: The percentage of discrete or regional EEGs were respectively 26, 52, 70, and 10% in frontal lobe epilepsy (FLE), lateral temporal lobe epilepsy, occipital lobe epilepsy (OLE), and parietal lobe epilepsy (PLE). The ictal rhythms in the order of frequency were theta, delta, beta, alpha, and rhythmic spike-and-wave. The duration of discrete or regional ictal rhythms were significantly shorter in FLE and PLE than in other epilepsies. Ictal beta activ-ity was the most common rhythm in discrete-patterned EEGs. There were some tendencies of poor lateralization in the presence of structural lesion. Types of seizure were not related with the degree of localization except for simple partial seizure. CONCLUSIONS: Ictal surface EEG was clinically helpful in the localization of epileptogenic foci especially in particular neocortical epileptic syndromes.
Electrodes ; Electroencephalography* ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Frontal Lobe ; Epilepsy, Temporal Lobe ; Humans ; Parietal Lobe ; Retrospective Studies ; Scalp ; Seizures

PURPOSE: The aim of this study was to investigate the speech problems in benign rolandic epilepsy (BRE) according to the seizure focus in EEG and semiology. METHODS: Twenty three patients [right origin (13 patients) or left side (10 patients)] who met the BRE criteria by International League Against Epilepsy (ILAE) were prospectively enrolled. We excluded the patients who had abnormal MRI or showed both side spikes in EEG. Computerized Speech Lab was used to assess the speech characteristics of the patients. RESULTS: The error pattern of laryngeal articulation in BRE was exclusively substitution of stop consonants, these errors showed more frequent in the left group (16.0% vs 25.5%). Voice onset time (VOT) of stop consonants and Total duration (TD) of word in both groups were prolonged than normal control group, especially in left group (P<0.05). The first formant of vowel /o/ and second formant of /e/ were significantly decreased in left group (P<0.05). The right group scored wider on pitch range (192.9+/-54.0 Hz) and energy range in spontaneous speech (14.2+/-6.4 dB) than the left group (233.3+/-12.5 Hz, 19.4+/-9.3 dB, respectively, P>0.05). Duration of counting (5 to 9) in left group slower than right group (8.6+/-1.7 vs 7.9+/-1.8 sec). CONCLUSION: Our data suggested that interictal spikes and seizures in either centrotemporal sides, especially left side group, may induce speech problems. We recommend the logopedic and phoniatric evaluations of speech in BRE patients.
Acoustics* ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Epilepsy, Rolandic ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Seizures ; Voice

PURPOSE: The benign childhood epilepsy with centrotemporal spikes (BECTS), commonly affecting children between 3 and 13 years of age, is focal epilepsy with the presence of centrotemporal spikes on electroencephalography (EEG). The aim of our study was to assess the relationship between EEG findings and clinical prognosis in patients with BECTS. METHODS: From 2005 to 2010, patients with a diagnosis of BECTS with a follow-up period of over one year after the diagnosis were included in our study. We analyzed their first interictal EEG: frequency of interictal discharges and average voltage in each waking and sleep phase. In addition, multiple factors were reviewed from the medical records: the age at the time of seizure onset, frequency of seizures, use of antiepileptic drugs (AEDs), duration of AED therapy, age at the time of EEG normalization and age at the time of last seizure. RESULTS: Seventy-four patients were included in our study. Frequent interictal epileptiform discharges during sleep correlated with younger age of seizure onset (P=0.040), earlier onset of AED therapy (P=0.022), younger age at the time of seizure cessation (P=0.027), greater frequency of interictal epileptiform discharges during wakefulness (P=0.006), higher average voltage (P=0.001) and higher frequency of seizures after AED initiation (P=0.043). CONCLUSION: In BECTS patients, frequent interictal epileptiform discharges during sleep could be correlated with higher seizure frequency, even after cessation of AED. These findings would be helpful in predicting the prognosis of children with BECTS.
Anticonvulsants ; Child ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Rolandic ; Follow-Up Studies ; Humans ; Prognosis ; Seizures ; Wakefulness

Laughter as an epileptic phenomenon is very uncommon. The introduction of the term gelastic epilepsy by Daly and Mulder (1957) may have resulted in less precision in diagnosis. Laughter does not necessarily include Mirth (gelos). Smiling may be volumtary or barely perceptible, whereas the laryngeal and respiratory components of laughter are more likely to be involuntary and are definite. To this time the loction of this epilepsy is said to be related with temporal lobe and hypothalamus. This case which we present with reviewing of the literature has paroxysmally a burst of loud, high-pitched laughter without any emotional expression. It suggests that at the production of this laughter some fasciorespiratory pathways might be involved, and that the start of this epileptic discharge is probably from a lesion of the orbito-frontal area.
Diagnosis ; Epilepsies, Partial* ; Epilepsy ; Hypothalamus ; Laughter ; Smiling ; Temporal Lobe

PURPOSE: Benign childhood epilepsy with centrotemporal spikes (BECTS) is one of the most common and benign focal epilepsy syndromes during childhood. In this study, we analyzed the clinical features and electroencephalogram (EEG) of BECT patients to determine if there were any predictive factors for seizures or abnormal EEG findings lasting longer than the average. METHODS: We studied 49 patients who were diagnosed with BECTS at the Department of Pediatrics, Chonnam National University Hospital and were 18 years of age or older at the time of the study. Differences in clinical course according to EEG features, treatment duration, abnormal EEG duration, seizure development period, and time to achieving the first normal EEG were analyzed. RESULTS: Average onset age was 8.3±1.9 years and follow-up duration was 4.2±2.4 years. The average seizure-free age was 9.5±2.0 years, and abnormal EEG-free age was 11.6±2.1 years. Younger-onset patients had a longer duration of medication (P=0.04). Patients who needed shorter time to achieving the first normal EEG had a shorter seizure development period (P=0.02). Patients who did not show typical EEG findings consistent with BECTS had a significantly longer duration of medication (P<0.01) and seizure development period (P=0.02), and abnormal EEG duration (P= 0.01). The ratio of abnormal findings in the first three EEGs was significantly correlated with the seizure development period, abnormal EEG duration, and duration of medication (P<0.01). CONCLUSION: Although BECTS is known to take a benign course, the actual clinical course varied from patient to patient, and these variations may be predicted by analyzing clinical factors or EEGs.
Age of Onset ; Child* ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Rolandic ; Follow-Up Studies ; Humans ; Jeollanam-do ; Pediatrics ; Seizures

No abstract available.
Epilepsies, Partial* ; Paragonimiasis*

Child ; Epilepsies, Partial ; Humans

Epilepsia syndromes in children, commonly happen as simple partial seizures without impairing consciousness, and usually are overlooked. In this article, the authors described some simple partial seizures which mostly wer overlooked through different previous clinical examinations. Owing to carefully taking the history of the disease from the parents relating some highly suggestive events such as somnambulism, distraction, repetitive stomach and headache without any physical lesion, and particularly owing to the specific device almost patients have been.
Epilepsies, Partial ; Child

Epilepsies, Partial ; Humans ; Syndrome