Scalp EEG-recorded high-frequency oscillations can predict seizure activity in Panayiotopoulos syndrome

Takako Fujita; Yukiko Ihara; Hitomi Hayashi; Takahito Inoue; Shinichiro Nagamitsu; Sawa Yasumoto; Shozo Tobimatsu

doi:10.1016/j.clinph.2023.09.015

Scalp EEG-recorded high-frequency oscillations can predict seizure activity in Panayiotopoulos syndrome

Clin Neurophysiol. 2023 Dec:156:106-112. doi: 10.1016/j.clinph.2023.09.015. Epub 2023 Oct 13.

Authors

Takako Fujita¹, Yukiko Ihara², Hitomi Hayashi³, Takahito Inoue⁴, Shinichiro Nagamitsu⁵, Sawa Yasumoto⁶, Shozo Tobimatsu⁷

Affiliations

¹ Department of Pediatrics, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: takfuji@fukuoka-u.ac.jp.
² Department of Pediatrics, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: yukira@fukuoka-u.ac.jp.
³ Department of Pediatrics, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: hayashihitomi@fukuoka-u.ac.jp.
⁴ Department of Pediatrics, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: inouet@fukuoka-u.ac.jp.
⁵ Department of Pediatrics, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: snagamit@fukuoka-u.ac.jp.
⁶ Center of Medical Education, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jyounan-ku, Fukuoka 814-0180, Japan. Electronic address: yasumosw@fukuoka-u.ac.jp.
⁷ Department of Orthoptics, Faculty of Medicine, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-ku, Fukuoka 814-0001, Japan. Electronic address: tobimatsu.shozo.592@m.kyushu-u.ac.jp.

PMID: 37918221
DOI: 10.1016/j.clinph.2023.09.015

Abstract

Objective: We studied the relationship between the clinical course of Panayiotopoulos syndrome (PS) and high-frequency oscillations (HFOs) captured during interictal scalp electroencephalography (EEG) to determine the feasibility of using HFOs to detect seizure activity in PS.

Methods: We analyzed the interictal scalp EEGs of 18 children with PS. Age parameters, seizure frequencies, and antiepileptic drugs were compared between the HFO-positive (HFOPG) and HFO-negative (HFONG) groups.

Results: Thirteen patients (72.2%) had HFOs while five patients (27.8%) had no HFOs in 194 interictal EEG records. We found no statistically significant differences in the mean age of epilepsy onset and last seizure, seizure frequency, or frequency of status epilepticus. However, the seizure activity period of the HFOPG was significantly longer than that of the HFONG. Patients with an HFO duration longer than 2 years were intractable to treatment. In most cases, seizures did not occur in the absence of HFOs, even when the spikes remained.

Conclusions: HFOs are related to the seizure activity period in patients with PS.

Significance: We propose that HFOs are a biomarker of epileptogenicity and an indicator for drug reduction because seizures did not occur if HFOs disappeared even if the spikes remained.

Keywords: Epileptogenicity; High-frequency oscillations; Panayiotopoulos syndrome; Seizure activity period; scalp EEG.

MeSH terms

Child
Electroencephalography
Epilepsies, Partial* / diagnosis
Epilepsy* / diagnosis
Humans
Scalp
Seizures / diagnosis