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DOI: 10.1055/s-0031-1277160
© Georg Thieme Verlag KG Stuttgart · New York
Abnormal Fast Activity before the Onset of West Syndrome
Publikationsverlauf
received 16.05.2010
accepted 06.04.2011
Publikationsdatum:
02. Mai 2011 (online)
Abstract
In our sequential EEG study performed on 68 infants with various pre- and perinatal brain insults, we found peculiar abnormal fast activity (AFAs) in 12 patients. 9 of the 12 patients with AFAs later developed West syndrome (WS) compared with only 3 of the 56 patients without AFAs (p<0.001, χ2 test). We analyzed these AFAs using EEG topography, and compared them with ictal fast activity (IFA) corresponding to tonic spasms observed later in the same patients after they had developed WS. We also investigated the clinical and EEG features in these patients. AFAs were first observed commonly at 4–5 months of CA, before the onset of WS. AFA topographic maps revealed posterior predominance in 11 of the 12 patients; IFA maps also showed posterior predominance but were more widely distributed. We propose that, though AFAs and IFAs are different, they share certain aspects of their pathophysiology, and that the maturational process of the occipital cortex plays an important role in the shared aspects. Since AFAs are observed before the onset of WS, they can be considered a sign that WS is imminent.
Key words
West syndrome - infantile spasms - abnormal fast activity - topographic analysis - ictal EEG
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Correspondence
Fumika Endoh
Department of Child Neurology
Okayama University Graduate
School of Medicine
Dentistry and Pharmaceutical
Sciences
2-5-1 Shikata-cho
700-8558 Okayama
Japan
Telefon: +81/86/235 7372
Fax: +81/86/235 7377
eMail: endohf@md.okayama-u.ac.jp