EEG analysis of subclinical seizures in frontotemporal lobe epilepsy_Journal of Epilepsy

Authors：

LV Hui ,  YU Qin , HAN Yenan , YAO Xiaojuan , CHEN Yin , CHEN Zhijuan , YANG Weidong

Dapartment of Neurology, Western Theater Air Force Hospital, Chendu 610021, China;

Corresponding author：

YU Qin, Email: yq_yuqing@163.com

Keywords：

Subclinical seizures; Clinical seizures; Temporal lobe epilepsy; Frontal lobe epilepsy; Video electroencephalogram

DOI：

10.7507/2096-0247.202111003

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the EEG characteristics and clinical significance of subclinical epilepsy from frontotemporal lobe.Methods A collection of patients with epilepsy who had subclinical seizures monitored by 24-hour video EEG from January 2020 to January 2021 in the Neurology Department of General Hospital of Tianjin Medical University General Hospital, and analyzed the duration of seizures and the number of seizures on the EEG.The characteristics and clinical significance of onset time (sleep period/waking period), interictal discharge, and number of leads involved in seizures.Results A total of 18 patients were enrolled, and 280 clinical seizures (11/18) and 34 clinical seizures (9/18) were captured. Among them, 2 patients had both subclinical seizures and clinical seizures. Frontal lobe origin, 235 subclinical seizures and 15 clinical seizures; temporal lobe origin, 26 subclinical seizures and 19 clinical seizures; frontotemporal lobe origin, subclinical seizures 19 times, no clinical seizures were captured. In the subclinical seizure group (11/18), there were 163 sleep episodes (58.2%) and 117 (41.8%) during waking phase; in the clinical seizure group (9/18), 16 episodes during sleep (47.1%) , 18 seizures (52.9%) in the awake period. Among the leads involved in seizures, <6 leads, 270 subclinical seizures, and no clinical seizures; ≥6 leads, subclinical seizures 10 times, and 34 clinical seizures. In the total duration of seizures: the clinical seizure group was (27.43±17.73) s, with a median value of 30s; the subclinical seizure group was (20.10±15.68) s, with a median value of 13 s. In the analysis of Spearman related factors, the subclinical seizure group was positively correlated with the sleep period (P=0.000), and negatively correlated with the normal nuclear magnetic field (P=0.004).Conclusion The epilepsy originated from the frontotemporal lobe has the characteristics of short clinical seizures, fewer leads involved, more likely to occur during sleep, and subclinical seizures that are more likely to occur when the MRI is abnormal. Therefore, strengthening the monitoring of long-term video EEG for patients with epilepsy and attaching importance to the interpretation of EEG during sleep will help to detect the subclinical seizures of patients and further improve the management of patients with epilepsy.

Citation： LV Hui, YU Qin, HAN Yenan, YAO Xiaojuan, CHEN Yin, CHEN Zhijuan, YANG Weidong. EEG analysis of subclinical seizures in frontotemporal lobe epilepsy. Journal of Epilepsy, 2022, 8(2): 116-122. doi: 10.7507/2096-0247.202111003 Copy

1.	Akman CI, Montenegro MA, Jacob S, et al. Subclinical seizures in children diagnosed with localization-related epilepsy: clinical and EEG characteristics. Epilepsy Behav, 2009, 16(1): 86-98.
2.	Jin B, Wang S, Yang L, et al. Prevalence and predictors of subclinical seizures during scalp video-EEG monitoring in patients with epilepsy. Int J Neurosci, 2017, 127(8): 651-658.
3.	Napolitano CE, Orriols MA. Graduated and sequential propagation in mesial temporal epilepsy: analysis with scalp ictal EEG. J Clin Neurophysiol, 2010, 27(4): 285-291.
4.	Erturk CO, Sirin NG, Elmali AD, et al. Different faces of frontal lobe epilepsy: The clinical, electrophysiologic, and imaging experience of a tertiary center. Clin Neurol Neurosurg, 2021, 203: 106532.
5.	Brown E C, Matsuzaki N, Asano E. The transient effect of interictal spikes from a frontal focus on language-related gamma activity. Epilepsy Behav, 2012, 24(4): 497-502.
6.	Wang S, Jin B, Yang L, et al. Clinical value and predictors of subclinical seizures in patients with temporal lobe epilepsy undergoing scalp video-EEG monitoring. J Clin Neurosci, 2017, 44: 214-217.
7.	Aurangzeb S, Symmonds M, Knight RK, et al. LGI1-antibody encephalitis is characterised by frequent, multifocal clinical and subclinical seizures. Seizure, 2017, 50: 14-17.
8.	Morano A, Fanella M, Cerulli I E, et al. Seizures in autoimmune encephalitis: Findings from an EEG pooled analysis. Seizure, 2020, 83: 160-168.
9.	Wennberg R, Arruda F, Quesney LF, et al. Preeminence of extrahippocampal structures in the generation of mesial temporal seizures: evidence from human depth electrode recordings. Epilepsia, 2002, 43(7): 716-726.
10.	Zangaladze A, Nei M, Liporace JD, et al. Characteristics and clinical significance of subclinical seizures. Epilepsia, 2008, 49(12): 2016-2021.
11.	Bridgman PA, Malamut BL, Sperling MR, et al. Memory during subclinical hippocampal seizures. Neurology, 1989, 39(6): 853-856.
12.	Awad IA, Nayel MH, Luders H. Second operation after the failure of previous resection for epilepsy. Neurosurgery, 1991, 28(4): 510-518.
13.	Farooque P, Duckrow R. Subclinical seizures during intracranial EEG recording: are they clinically significant? Epilepsy Res, 2014, 108(10): 1790-1796.
14.	Velkey A, Siegler Z, Janszky J, et al. Clinical value of subclinical seizures in children with focal epilepsy. Epilepsy Res, 2011, 95(1-2): 82-85.
15.	King-Stephens D. The Value of localizing subclinical seizures. Epilepsy Curr, 2020, 20(3): 147-148.
16.	Spilioti M, Winston JS, Centeno M, et al. The nature, frequency and value of stimulation induced seizures during extraoperative cortical stimulation for functional mapping. Seizure, 2020, 81: 71-75.
17.	Tao JX, Baldwin M, Hawes-Ebersole S, et al. Cortical substrates of scalp EEG epileptiform discharges. J Clin Neurophysiol, 2007, 24(2): 96-100.

1. Akman CI, Montenegro MA, Jacob S, et al. Subclinical seizures in children diagnosed with localization-related epilepsy: clinical and EEG characteristics. Epilepsy Behav, 2009, 16(1): 86-98.
2. Jin B, Wang S, Yang L, et al. Prevalence and predictors of subclinical seizures during scalp video-EEG monitoring in patients with epilepsy. Int J Neurosci, 2017, 127(8): 651-658.
3. Napolitano CE, Orriols MA. Graduated and sequential propagation in mesial temporal epilepsy: analysis with scalp ictal EEG. J Clin Neurophysiol, 2010, 27(4): 285-291.
4. Erturk CO, Sirin NG, Elmali AD, et al. Different faces of frontal lobe epilepsy: The clinical, electrophysiologic, and imaging experience of a tertiary center. Clin Neurol Neurosurg, 2021, 203: 106532.
5. Brown E C, Matsuzaki N, Asano E. The transient effect of interictal spikes from a frontal focus on language-related gamma activity. Epilepsy Behav, 2012, 24(4): 497-502.
6. Wang S, Jin B, Yang L, et al. Clinical value and predictors of subclinical seizures in patients with temporal lobe epilepsy undergoing scalp video-EEG monitoring. J Clin Neurosci, 2017, 44: 214-217.
7. Aurangzeb S, Symmonds M, Knight RK, et al. LGI1-antibody encephalitis is characterised by frequent, multifocal clinical and subclinical seizures. Seizure, 2017, 50: 14-17.
8. Morano A, Fanella M, Cerulli I E, et al. Seizures in autoimmune encephalitis: Findings from an EEG pooled analysis. Seizure, 2020, 83: 160-168.
9. Wennberg R, Arruda F, Quesney LF, et al. Preeminence of extrahippocampal structures in the generation of mesial temporal seizures: evidence from human depth electrode recordings. Epilepsia, 2002, 43(7): 716-726.
10. Zangaladze A, Nei M, Liporace JD, et al. Characteristics and clinical significance of subclinical seizures. Epilepsia, 2008, 49(12): 2016-2021.
11. Bridgman PA, Malamut BL, Sperling MR, et al. Memory during subclinical hippocampal seizures. Neurology, 1989, 39(6): 853-856.
12. Awad IA, Nayel MH, Luders H. Second operation after the failure of previous resection for epilepsy. Neurosurgery, 1991, 28(4): 510-518.
13. Farooque P, Duckrow R. Subclinical seizures during intracranial EEG recording: are they clinically significant? Epilepsy Res, 2014, 108(10): 1790-1796.
14. Velkey A, Siegler Z, Janszky J, et al. Clinical value of subclinical seizures in children with focal epilepsy. Epilepsy Res, 2011, 95(1-2): 82-85.
15. King-Stephens D. The Value of localizing subclinical seizures. Epilepsy Curr, 2020, 20(3): 147-148.
16. Spilioti M, Winston JS, Centeno M, et al. The nature, frequency and value of stimulation induced seizures during extraoperative cortical stimulation for functional mapping. Seizure, 2020, 81: 71-75.
17. Tao JX, Baldwin M, Hawes-Ebersole S, et al. Cortical substrates of scalp EEG epileptiform discharges. J Clin Neurophysiol, 2007, 24(2): 96-100.

Journal of Epilepsy

EEG analysis of subclinical seizures in frontotemporal lobe epilepsy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content