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Related Experiment Videos

A newly described ictal pattern: the initial ictal slow shift.

John R Hughes1, John J Fino, Ketan Patel

  • 1Epilepsy Clinic, University of Illinois Medical Center, M/C 796, 912 S. Wood Street, Room 862N, Chicago, IL 60612, USA. jhughes@uic.edu

Clinical EEG and Neuroscience
|September 1, 2005
PubMed
Summary

A newly identified initial ictal slow shift (IS) pattern precedes typical seizure rhythms in subdural and scalp EEG recordings. This finding offers new insights into the electrophysiological dynamics of seizure onset and offset.

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Area of Science:

  • Neuroscience
  • Clinical Electrophysiology

Background:

  • Epilepsy diagnosis relies on identifying characteristic electroencephalogram (EEG) patterns.
  • Understanding the earliest electrophysiological changes during seizures is crucial for accurate diagnosis and treatment.

Observation:

  • A novel ictal pattern, the initial ictal slow shift (IS), has been described.
  • This pattern manifests as a positive or negative voltage shift preceding or following typical seizure rhythms in both subdural and scalp EEG.
  • Specific characteristics include duration, amplitude (up to 15 mV in subdural, 600 microV in scalp), and timing relative to seizure discharges.

Findings:

  • The initial ictal slow shift (IS) can serve as an early indicator of seizure onset, appearing before established ictal rhythms.
  • In absence seizures, slow shifts are observed both before and after the typical 3/sec bilateral spike and wave (S+W) complexes.

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  • Post-ictal slow shifts may correlate with the duration of impaired responsiveness following seizure termination.

    • Implications:

    • The initial ictal slow shift (IS) pattern may improve the detection and localization of seizure origins.
    • Characterizing these slow shifts could refine EEG interpretation and diagnostic criteria for various epilepsy types.
    • Further research into the neurophysiological basis of these shifts may enhance our understanding of seizure pathophysiology.