Postictal electroencephalographic (EEG) suppression: A stereo-EEG study of 100 focal to bilateral tonic-clonic seizures.

摘要: OBJECTIVES We aimed to describe intracerebral aspects of postictal generalized electroencephalography suppression (PGES) following focal bilateral tonic-clonic ("secondarily tonic-clonic") seizures (GTCS) recorded using stereoelectroencephalographic (SEEG), and correlate these with electroclinical features. METHODS Three independent observers scored semiologic SEEG Patient epilepsy characteristics were collected. Descriptive statistics multivariate analysis performed. The operational definition PGES on used strict criteria (absence visible signal at 20 μV/mm amplitude, in all readable channels). Postictal regional (RS) was identified if only a subset implanted electrodes showed absence signal. RESULTS evaluated 100 52 patients. Interobserver agreement good (κ 0.72 for clinical features 0.73 EEG features). present 27 RS without 42 seizures. Region included epileptogenic zone 43 51 (86%). No effect sampling (multilobar or exploration) seen. Oral tonicity (mouth opening and/or tonic vocalization during the phase GTCS) associated presence (P = 0.029; negative predictive value [NPV] 0.91). Bilateral upper limb extension correlated (P = 0.041; NPV 0.85). Association both oral had high 0.96. SIGNIFICANCE recordings confirm true suppression. is unlikely when are absent. hypothesize that seizure discharge bulbar level brainstem regions production signs may relate mechanisms PGES.