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EDITED BY PROFESSOR YASSER METWALLY |
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Role of EEG in epileptic syndromes associated
with myoclonus |
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EEG is an essential component in the evaluation of epilepsy. The EEG
provides important information about background EEG and epileptiform
discharges and is required for the diagnosis of specific
electroclinical syndromes. Such a diagnosis carries important
prognostic information, guides selection of antiepileptic medication,
and suggests when to discontinue medication. Following a seizure (ie,
during the postictal period) the EEG background may be slow. However,
interictal background EEG frequencies that are slower than normal for
age usually suggest a symptomatic epilepsy (epilepsy secondary to
brain insult). Normal background suggests primary epilepsy
(idiopathic or possibly genetic epilepsy). Thus EEG background offers
important prognostic and classification information.".Click
here for the whole story |
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Lennox -Gastaut syndrome (LGS) |
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Lennox-Gastaut syndrome is a childhood (onset 3-5 years) epileptic
encephalopathy that manifests with atonic seizures, tonic seizures,
and atypical absence seizures associated with mental retardation and
a characteristic EEG pattern. Infantile spasms and West syndrome
frequently transform into LGS. Unlike West syndrome, LGS tends to be
a lifelong epileptic encephalopathy. EEG shows an abnormally slow
background and diffuse slow spike and slow wave (<2.5 Hz)
activity. The slow spike and wave activity serves to differentiate
(poor-prognostic) LGS from absence epilepsy, in which diffuse 3Hz
spike and wave of benign absence is seen and the fast spike and wave
(>2.5 Hz) activity often seen with some of the more benign
myoclonic types of epilepsy. Prognosis of fast and slow spike and
wave activity is dramatically different; it is poor for slow spike
and wave activity seen in LGS. Many epilepsy syndromes overlap with
LGS, including myoclonic astatic epilepsy of Doose and other severe
myoclonic epilepsies.. Click
here for the whole story |
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Juvenile myoclonic epilepsy (JME) |
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JME is the most common epilepsy syndrome presenting with generalized
tonic-clonic seizures between 12-30 years in a patient who is
otherwise neurologically normal. It may account for up to 10% of all
patients with epilepsy. Imaging studies are normal. In susceptible
persons, sleep deprivation often precipitates seizures. Typically,
the patient may experience myoclonic jerks in the morning, although
many patients do not mention that they are having myoclonic seizures
until asked specifically about body jerks..Click
here for the whole story |
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