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Somatosensory evoked spikes and epileptic seizures: a study of 385 cases
1Department of Neuropsychiatry, Pontificia Universidade Católica de Campinas, Brazil.
Insights
Stimulation-evoked potentials (SES) in children are linked to epilepsy risk. Specific SES characteristics and EEG activity predict seizures, especially in benign childhood epilepsy syndromes.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Stimulation-evoked potentials (SES) are EEG responses to sensory input.
- Understanding SES in children may offer insights into neurological conditions.
Purpose of the Study:
- To investigate the relationship between SES characteristics and epileptic seizures in children.
- To characterize epileptic syndromes associated with specific SES findings.
Main Methods:
- Electroencephalography (EEG) was performed on 385 children, noting SES evoked by foot or hand taps.
- Children were assessed for epilepsy, febrile convulsions, and other neurological complaints.
- EEG data, including spontaneous epileptiform activity, were analyzed in relation to SES and seizure occurrence.
Main Results:
- Ninety-one children (23.6%) had epilepsy. Epilepsy risk increased with multiphasic/high-amplitude foot-tap SES, hand-stimulation SES, and spontaneous EEG epileptiform activity.
- Commonly diagnosed syndromes included benign childhood epilepsy with centrotemporal spikes (21 cases) and "partial idiopathic others" (43 cases).
- SES were often observed without cerebral lesions, suggesting functional mechanisms, and were associated with various partial and generalized epilepsies, particularly benign parietal lobe epilepsy.
Conclusions:
- Certain SES characteristics and concurrent EEG abnormalities are associated with an increased risk of epileptic seizures in children.
- SES findings can be relevant in the diagnosis and characterization of childhood epilepsy syndromes.
- The study suggests an age-related, functional mechanism underlying SES in children, often without evidence of organic brain damage.
Abstract:
We examined 385 children whose EEG showed high voltage potentials evoked by taps applied to one or both feet or hands (SES). The relationship between characteristics of SES and the occurrence of epileptic seizures and the characterization of epileptic syndromes were studied. Ninety-one children (23.6%) had epilepsy, 42 (10.9%) had only febrile convulsions and 252 children had other complaints. Epilepsy occurred in a higher proportion of cases when: SES by foot tapping were multiphasic, with high amplitude or SES were obtained by hand stimulation and there was spontaneous epileptiform activity in the EEG. The following epileptic syndromes were diagnosed: benign childhood epilepsy with centrotemporal spikes in 21 cases, benign epilepsy of childhood with occipital paroxysms in 2, benign psychomotor epilepsy in 1, "partial idiopathic others" in 43, generalized idiopathic in 8, symptomatic epilepsies in 13 and undetermined in 3 cases. In most cases SES were observed in children without evidence of cerebral organic lesion, suggesting the existence of an age-related, functional mechanism. Some characteristics of SES and the occurrence of spontaneous epileptiform activity showed a positive association with epileptic seizures. SES occurred in different types of partial and generalized epilepsies of childhood but in nearly 50% of the cases with epilepsy, there was a benign condition involving mainly the parietal lobe with versive, unilateral and sleep-generalized seizures.