Atypical Interictal Epileptiform Discharges in Electroencephalography
A Bruce Janati1, Naif Saad ALGhasab2, Maram Youseef Aldaife2
1Neurology Center of Fairfax, Fairfax, VA, USA.
Journal of Epilepsy Research
|February 28, 2019
Summary
Atypical interictal epileptiform discharges (IEDs) like positive sharp waves are rare EEG patterns indicating focal epilepsy. Neuroimaging is crucial for identifying potential congenital central nervous system anomalies in patients with these findings.
Area of Science:
- Neuroscience
- Clinical Neurology
- Epileptology
Background:
- Typical interictal epileptiform discharges (IEDs) are well-documented in EEG.
- Atypical IEDs, including positive sharp waves (PSWs), focal triphasic sharp waves and spikes (FTSWs), sharp slow waves (SSWs), bifid spikes, and notched delta, are under-reported.
- Limited data exists on the pathophysiology, characteristics, and diagnostic significance of these atypical IEDs.
Purpose of the Study:
- To investigate the pathophysiology, characteristics, and diagnostic significance of various atypical IEDs.
- To highlight the clinical relevance of under-reported EEG patterns.
- To explore the association between atypical IEDs and underlying neurological conditions.
Main Methods:
- Prospective review of electroencephalography (EEG) data from 1,250 patients over 2 years.
- Documentation of demographic, clinical, and neuroimaging data for patients with atypical IEDs.
- Analysis of specific atypical IED types: PSWs, FTSWs, SSWs, notched delta, and bifid spikes.
Main Results:
- Atypical IEDs were identified in a subset of patients, with varying frequencies for each type.
- High rates of epilepsy diagnosis were observed across all studied atypical IED groups (75%-100%).
- A significant proportion of patients with atypical IEDs were younger and had congenital central nervous system anomalies.
Conclusions:
- Atypical IEDs are rare but significant EEG patterns potentially indicating focal epileptogenicity.
- These findings underscore the importance of neuroimaging for detecting underlying congenital central nervous system anomalies in patients presenting with atypical IEDs.
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