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EDITED BY PROFESSOR YASSER METWALLY

February 2009

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Role of EEG in epileptic syndromes associated with myoclonus

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

Lennox -Gastaut syndrome (LGS)

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

Juvenile myoclonic epilepsy (JME)

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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