Analysis of rapidly changing EEGs before generalized spike and wave complexes.

Ten epileptic patients who had absence and tonic-clonic seizures were examined. They showed almost generalized 2-5 Hz spike and wave complexes (SWCs) with maxima at the frontal or central locations. Their EEGs were recorded from F3, F4, C3, C4, P3, P4, O1 and O2. One 15 sec EEG epoch, which included the background activity followed by SWCs, was divided into 20 segments. On the basis of Akaike's information criterion obtained from an AR model fitted to each segment by the least squares method, a distance measure between segments was obtained. The 20 segments were classified according to the distance measure with the combined use of both cluster analysis and multidimensional scaling. The power spectrum was also obtained for each segment. There were 2-6 clusters at some locations, always including the largest amplitude locations of the SWCs (the frontal or central locations). The clusters could be grouped into 3 major types, each forming a period: (1) one large cluster distant from the SWCs (the period of background activity); (2) small clusters just before the SWCs (the period just before the SWCs); (3) small clusters during the SWCs (the period of the SWCs). The period just before the SWCs, which occurred earliest at the largest amplitude location, may be a transition state of the background activity to the SWCs. A few segments remote from the SWCs belonged to the small cluster just before or during the SWCs in some patients, thus suggesting that an EEG event similar to EEG changes just before or during the SWCs occurred. The EEG event buried within the background can be considered as a poorly developed epileptiform discharge. A gradual increase or decrease in alpha frequency before the SWCs was found in most patients; this suggests that changes in the level of vigilance occur before SWCs.