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Updated: Feb 13, 2026

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
10:22

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Published on: December 6, 2016

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Interictal regional paroxysmal fast activity on scalp EEG is common in patients with underlying gliosis

Gopal Krishna Dash1, Chaturbhuj Rathore1, Malcolm K Jeyaraj1

  • 1R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|March 20, 2018
PubMed
Abstract

Insights

Regional paroxysmal fast activity (RPFA) on EEG is often seen in focal cortical dysplasia. This study finds focal gliosis is a more common cause of RPFA, especially in developing countries.

Area of Science:

  • Neurology
  • Epileptology
  • Neurophysiology

Background:

  • Interictal regional paroxysmal fast activity (RPFA) on scalp electroencephalography (EEG) is frequently observed in patients with focal cortical dysplasia (FCD).
  • Limited data exists on the association between RPFA and other epilepsy etiologies.

Purpose of the Study:

  • To investigate the relationship between RPFA and specific magnetic resonance imaging (MRI) findings in patients with drug-resistant focal epilepsy.
  • To identify the underlying causes of RPFA in epilepsy patients undergoing presurgical evaluation.

Main Methods:

  • A retrospective study of 626 patients with drug-resistant focal epilepsy evaluated between 2011 and 2012.
  • RPFA was defined by specific EEG criteria (≥3 spikes, ≥10 Hz, 300 ms–4 s duration).
  • Analysis of MRI findings to determine epilepsy etiology in patients with and without RPFA.

Main Results:

  • 138 out of 626 patients (22%) exhibited RPFA.
  • Focal gliosis (44%) and FCD (19%) were the most common etiologies in patients with RPFA.
  • Patients with RPFA were significantly more likely to have focal gliosis (p<0.0001) or FCD (p<0.001) compared to those with other interictal epileptiform discharges.

Conclusions:

  • Focal gliosis is a significant underlying etiology for RPFA on scalp EEG.
  • In developing countries, focal gliosis is more prevalent than FCD as a cause of RPFA.
Keywords:
Drug resistant epilepsyFocal cortical dysplasiaGliosisRegional paroxysmal fast activity

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