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Interictal regional polyspikes in noninvasive EEG suggest cortical dysplasia as etiology of focal epilepsies

  1. Soheyl Noachtar1,
  2. Özgür Bilgin2,
  3. Jan Rémi1,
  4. Nelly Chang1,
  5. Ipek Midi2,
  6. Christian Vollmar1,
  7. Berend Feddersen1

Article first published online: 21 MAR 2008

DOI: 10.1111/j.1528-1167.2008.01583.x

Issue

Epilepsia

Epilepsia

Volume 49, Issue 6, pages 1011–1017, June 2008

Additional Information

How to Cite

Noachtar, S., Bilgin, Ö., Rémi, J., Chang, N., Midi, I., Vollmar, C. and Feddersen, B. (2008), Interictal regional polyspikes in noninvasive EEG suggest cortical dysplasia as etiology of focal epilepsies. Epilepsia, 49: 1011–1017. doi: 10.1111/j.1528-1167.2008.01583.x

Author Information

  1. 1

    Department of Neurology, Epilepsy Center, University of Munich, Munich, Germany

  2. 2

    Department of Neurology, Marmara University Hospital, Istanbul, Turkey

*Address correspondence to Prof. Dr. Soheyl Noachtar, Department of Neurology, University of Munich, Marchioninistr. 15, 81337 Munich, Germany. E-mail: noa@med.uni-muenchen.de

Publication History

  1. Issue published online: 21 MAR 2008
  2. Article first published online: 21 MAR 2008
  3. Accepted February 15, 2008; Online Early publicationMarch 21, 2008.

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Keywords:

  • EEG;
  • Cortical dysplasia;
  • Regional polyspikes;
  • Epilepsy monitoring

Summary

Purpose: To evaluate the clinical significance of interictal regional polyspikes in focal epilepsies secondary to cortical dysplasia.

Methods: We performed a data search for the term “regional polyspikes” in the database of our epilepsy-monitoring unit. Patients with generalized epilepsies including Lennox-Gastaut syndrome were excluded. Regional interictal epileptiform discharges were recorded in 513 patients with noninvasive EEG.

Results: We identified 29 patients with interictal regional polyspikes and focal epilepsies. Another 484 patients showed regional epileptiform discharges other than polyspikes. The etiology of the epilepsy was significantly more frequently cortical dysplasia in the group of patients with regional polyspikes (35%, 10 of 29 patients) than in the patients with other regional epileptiform discharges (5%, 24 of 484 patients) (p < 0.01). The polyspikes were significantly more frequently localized to the extratemporal (72%; n = 21) than temporal (28%; n = 8) regions (p < 0.01). In contrast, regional epileptiform discharges other than polyspikes were significantly more frequently localized to the temporal lobe (75%; n = 362) than extratemporal regions (25%; n = 122) (p < 0.01). Eight of the 10 patients with focal cortical dysplasia had extratemporal polyspikes.

Discussion: Noninvasively recorded regional polyspikes suggest cortical dysplasias as etiology of predominantly extratemporal epilepsies.

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