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Age-Dependency of Location of Epileptic Foci in "Continuous Spike-and-Waves during Sleep": A Parallel to the Posterior-Anterior Trajectory of Slow Wave Activity


Heinzle, Bigna Katrin Bölsterli; Bast, Thomas; Critelli, Hanne; Huber, Reto; Schmitt, Bernhard (2016). Age-Dependency of Location of Epileptic Foci in "Continuous Spike-and-Waves during Sleep": A Parallel to the Posterior-Anterior Trajectory of Slow Wave Activity. Neuropediatrics, 48(01):036-041.

Abstract

Background: Epileptic encephalopathy with continuous spike-and-waves during sleep (CSWS) occurs during childhood and is characterized by an activation of spike wave complexes during slow wave sleep. The location of epileptic foci is variable, as is etiology. A relationship between the epileptic focus and age has been shown in various focal epilepsies following a posterior-anterior trajectory, and a link to brain maturation has been proposed.We hypothesize that in CSWS, maximal spike wave activity, corresponding to the epileptic focus, is related to age and shows a posterior-anterior evolution.
Findings: In a retrospective cross-sectional study on CSWS (22 EEGs of 22 patients aged 3.1-13.5 years), the location of the epileptic focus is related to age and follows a posterior-anterior course. Younger patients are more likely to have posterior foci than older ones.
Conclusions: We propose that the posterior-anterior trajectory of maximal spike waves in CSWS might reflect maturational changes of maximal expression of sleep slow waves, which follow a comparable course. Epileptic spike waves, that is, "hyper-synchronized slow waves" may occur at the place where the highest and therefore most synchronized slow waves meet brain tissue with an increased susceptibility to synchronization.

Abstract

Background: Epileptic encephalopathy with continuous spike-and-waves during sleep (CSWS) occurs during childhood and is characterized by an activation of spike wave complexes during slow wave sleep. The location of epileptic foci is variable, as is etiology. A relationship between the epileptic focus and age has been shown in various focal epilepsies following a posterior-anterior trajectory, and a link to brain maturation has been proposed.We hypothesize that in CSWS, maximal spike wave activity, corresponding to the epileptic focus, is related to age and shows a posterior-anterior evolution.
Findings: In a retrospective cross-sectional study on CSWS (22 EEGs of 22 patients aged 3.1-13.5 years), the location of the epileptic focus is related to age and follows a posterior-anterior course. Younger patients are more likely to have posterior foci than older ones.
Conclusions: We propose that the posterior-anterior trajectory of maximal spike waves in CSWS might reflect maturational changes of maximal expression of sleep slow waves, which follow a comparable course. Epileptic spike waves, that is, "hyper-synchronized slow waves" may occur at the place where the highest and therefore most synchronized slow waves meet brain tissue with an increased susceptibility to synchronization.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Psychiatric University Hospital Zurich > Center for Child and Adolescent Psychiatry
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:23 November 2016
Deposited On:16 Jan 2017 14:24
Last Modified:26 Jan 2017 02:04
Publisher:Georg Thieme Verlag
ISSN:0174-304X
Publisher DOI:https://doi.org/10.1055/s-0036-1593989
PubMed ID:27880966

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