Inter-ictal EEG patterns in malformations of cortical development and epilepsy

Area of Science:

• Neurology
• Epileptology
• Neurodevelopmental Disorders

Background:

• Malformations of Cortical Development (MCD) are a significant cause of refractory epilepsy.
• Understanding interictal EEG patterns in MCD is crucial for predicting clinical course and treatment outcomes.

Purpose of the Study:

• To evaluate scalp interictal EEG patterns in various types of MCD.
• To assess the association between EEG patterns, clinical features, and seizure control in patients with MCD and epilepsy.

Main Methods:

• Retrospective analysis of demographic, clinical, interictal EEG, and seizure outcome data.
• Included 665 patients with epilepsy and MCD with a minimum two-year follow-up.

Main Results:

• Multiregional spikes were more prevalent in children and those with early-onset epilepsy (<2 years) or polymicrogyria.
• Generalized epileptiform discharges were associated with developmental delay, lissencephaly, and heterotopias.
• Regional spikes were more common in focal cortical dysplasia (FCD) and with later epilepsy onset (>2 years).
• No significant association was found between interictal EEG patterns and seizure control, with 60.7% of patients experiencing refractory epilepsy.

Conclusions:

• Specific interictal EEG patterns correlate with distinct MCD subtypes and clinical characteristics.
• Interictal EEG patterns do not appear to influence seizure outcome in patients with MCD and epilepsy.