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Focal, continuous spikes suggest cortical developmental abnormalities. Clinical, MRI and neuropathological correlates
E Brodtkorb1, K Andersen, O Henriksen
1Department of Neurology, Trondheim University Hospital, Norway.
Acta Neurologica Scandinavica
|January 6, 1999
Summary
This study identifies a unique EEG pattern in adults with malformations of cortical development (MCD). This specific fast spiking pattern may indicate MCD but doesn't always predict severe epilepsy.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Malformations of cortical development (MCD) are a diverse group of congenital brain abnormalities.
- Magnetic Resonance Imaging (MRI) has improved the understanding of MCD heterogeneity.
- Some MCD patients exhibit characteristic electroencephalogram (EEG) abnormalities.
Observation:
- Three adult patients (32-36 years) with a rare EEG pattern of distinct, localized, fast, continuous spiking were studied.
- This EEG pattern was stable since childhood and posteriorly located.
- These patients represent the only cases with this specific EEG finding identified over nine years.
Findings:
- All patients showed MCD on MRI: hemimegalencephaly, subcortical heterotopia, and focal cortical dysplasia.
- Epilepsy was well-controlled in two patients; the third had intractable seizures requiring surgery, with histological confirmation of cortical dysplasia.
- All patients exhibited varying degrees of cognitive dysfunction.
Implications:
- Focal, continuous, fast spiking on scalp EEG is an uncommon finding.
- This EEG pattern may suggest an underlying MCD.
- The pattern is not a definitive predictor of severe epilepsy or a dysgenetic cause of epilepsy.