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Interictal spiking in adult newly-diagnosed focal epilepsy of unknown cause: The effect of age.

Authors :
Arbasino C
Calorio F
d'Orsi G
Marchioni E
Tartara E
Marchese D
Rustioni V
Moglia A
Galimberti CA
Source :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2015 Aug; Vol. 126 (8), pp. 1498-504. Date of Electronic Publication: 2014 Nov 15.
Publication Year :
2015

Abstract

Objective: To assess the yield of interictal EEG spiking in standard and whole-night sleep EEGs in elderly subjects with recent-onset focal seizures compared to younger patients.<br />Methods: Detection of interictal epileptiform abnormalities (IEAs) and rating of mean spike index (number of interictal discharges/minute) values for different sleep stages (NREM stages 1-2 and 3-4 and REM sleep) in standard EEG (S-EEG) and 24-h ambulatory EEG (A-EEG) at first referral in three groups of thirty consecutive outpatients [aged 20-39 (young), 40-59 (adults) and ⩾60years (elderly)], retrospectively selected according to a subsequent diagnosis of focal epilepsy of unknown cause, no sleep disorders or drugs or comorbidities affecting sleep and EEG.<br />Results: Elderly subjects showed a lower rate of IEAs on S-EEG (p<0.01) but a higher propensity for spiking during deep NREM sleep, 11/30 showing IEAs exclusively during stages 3-4. Mean spike index showed a significant increase in IEAs between sleep stages 1-2 and 3-4 in the elderly subjects (p<0.001).<br />Conclusions: A significant association emerged between IEAs during deep sleep and age (p<0.001).<br />Significance: EEG recordings covering deep NREM sleep should be recommended when IEAs detection is needed to support a diagnosis of epilepsy in elderly subjects.<br /> (Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1872-8952
Volume :
126
Issue :
8
Database :
MEDLINE
Journal :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Publication Type :
Academic Journal
Accession number :
25487912
Full Text :
https://doi.org/10.1016/j.clinph.2014.10.155