Electroencephalogram utilization and psychiatric comorbidities among children and adolescents with epilepsy in rural Southwestern Uganda.

OBJECTIVE: This study aimed at describing routine electroencephalogram (EEG) findings among children and adolescents with a clinical diagnosis of epilepsy and determines how interictal EEG abnormalities vary with the psychiatric comorbidities. METHODS: We conducted a cross-sectional study among children and adolescents with epilepsy aged 5-18 years receiving care from a regional referral hospital in Southwestern Uganda. Psychiatric comorbidities were assessed using an adapted parent version of Child and Adolescent Symptom Inventory-5. Thirty-minute EEG samples were taken from routine EEG recordings that were locally performed and remotely interpreted for all participants. RESULTS: Of the 140 participants, 71 (50.7%) had normal EEG findings and 51 (36.4%) had epileptiform abnormalities while 18 (12.9%) had non-epileptiform. Of those who had epileptiform abnormalities on EEG, 23 (45.1%) were focal, 26 (51.0%) were generalized, and 2 (3.9%) were focal with bilateral spread. There was no significant association between the different psychiatric comorbidities and the interictal EEG abnormalities. CONCLUSIONS: Among children and adolescents with a clinical diagnosis of epilepsy in Southwestern Uganda, only 36% showed epileptiform abnormalities on their EEG recordings. There was no association between the interictal EEG abnormalities and psychiatric comorbidities.

EEG frequency during spike-wave discharges may predict treatment outcome in patients with idiopathic generalized epilepsies.

We report findings concerning the relationship between electroencephalography (EEG) frequency during spike-and-wave discharges (SWDs) and response to treatment in 21 patients with idiopathic generalized epilepsy (IGE). We studied patients whose EEG contained SWDs lasting at least 4 s. Among these patients, two groups could be distinguished on the basis of a subtle difference in EEG frequency during the first 2 s of the burst. The two groups differed markedly in their clinical response to medication, with the group becoming seizure-free during the next 1-2 years showing a spike-wave onset frequency of > 3.2 Hz, and those not seizure-free < 3.2 Hz (p = 0.0034, sensitivity 75% and specificity 92%). Given this strong effect in a relatively small group, further work is needed to clarify the predictive value of this frequency measure for clinical outcomes in absence epilepsies.

A method for detecting false bifurcations in dynamical systems: application to neural-field models.

In this article, we present a method for tracking changes in curvature of limit cycle solutions that arise due to inflection points. In keeping with previous literature, we term these changes false bifurcations, as they appear to be bifurcations when considering a Poincaré section that is tangent to the solution, but in actual fact the deformation of the solution occurs smoothly as a parameter is varied. These types of solutions arise commonly in electroencephalogram models of absence seizures and correspond to the formation of spikes in these models. Tracking these transitions in parameter space allows regions to be defined corresponding to different types of spike and wave dynamics, that may be of use in clinical neuroscience as a means to classify different subtypes of the more general syndrome.