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Generalized spike-and-wave patterns in children: clinical correlates.
B Martínez-Menéndez1, A P Sempere, P P Mayor
1Pediatric Neurology Unit, Section of Neurology, H.U. de Getafe, Hospital 12 de Octubre, Madrid, Spain.
Pediatric Neurology
|February 11, 2000
Summary
This study analyzed electroencephalograms (EEGs) in 154 children with epilepsy, classifying generalized spike-and-wave (SW) patterns by frequency. Different SW patterns correlate with distinct epilepsy types, seizure characteristics, and prognoses, aiding in diagnosis and treatment strategies.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Electroencephalograms (EEGs) are crucial for diagnosing epilepsy in children.
- Generalized spike-and-wave (SW) patterns on EEGs are common in pediatric epilepsy.
- Classifying SW patterns by frequency may offer prognostic insights.
Purpose of the Study:
- To analyze the clinical characteristics of children with epilepsy exhibiting generalized SW patterns.
- To classify SW patterns based on their frequency and correlate them with clinical features.
- To determine the prognostic implications of different SW pattern frequencies in pediatric epilepsy.
Main Methods:
- Retrospective review of 154 pediatric EEGs performed between 1980 and 1990.
- Classification of generalized SW patterns according to their frequency (typical, slow, fast).
- Analysis of clinical data including seizure types, epilepsy syndromes, neurological examination, and neuroimaging (CT scans).
Main Results:
- Typical SW patterns were associated with absence seizures, normal findings, idiopathic generalized epilepsies, monotherapy, and seizure freedom.
- Slow SW patterns correlated with West syndrome, younger onset, various seizure types, abnormal findings, cryptogenic/symptomatic epilepsies, polytherapy, and poor seizure control.
- Fast SW patterns were linked to secondary generalized and partial seizures, normal CT scans, cryptogenic partial epilepsy, and seizure recurrence.
Conclusions:
- Epilepsy with typical SW patterns can be considered benign.
- Epilepsy with slow SW patterns suggests a malignant course.
- Epilepsy with fast SW patterns indicates a treacherous prognosis, necessitating careful management.