Balaram Neetha, Balachandran Smita, Gafoor Abdul V, Ratheesh S R
Department of Neurology, Government Medical College, Kozhikode, Kerala, India.
Department of Clinical Psychology, Institute of Mental Health and Neurosciences, Kozhikode, Kerala, India.
Ann Indian Acad Neurol. 2025 May 1;28(3):426-431. doi: 10.4103/aian.aian_899_24. Epub 2025 Jun 9.
The purpose of this study was to identify the pseudo spike-wave activation in sleep (SWAS) patterns in the electroencephalogram (EEG) of self-limited focal epilepsies of childhood (SeLFE) and study their clinical and electrical evolution. Sleep EEG and clinical data of children aged 2-12 years with SeLFE and pseudo-SWAS were collected retrospectively from our EEG database and were followed periodically every 6 months with clinical, EEG, and neurocognitive assessments. Nine children were identified and were grouped as follows: (a) pseudo-SWAS pattern caused by type 1 occipitofrontal spikes in five children, who had no clinical worsening on follow-up, and this pattern resolved within 3 years; (b) pseudo-SWAS pattern without occipitofrontal spikes in three children that was caused by diffusion of pre-existing focal spikes; and (c) pseudo-SWAS pattern induced by antiseizure medication in one child, which completely resolved on withdrawing the medication. Electro-clinical dissociation occurred in pseudo-SWAS, and none of them evolved to developmental and/or epileptic encephalopathy with SWAS. Identification of these patterns helps to avoid inadvertent use of antiseizure medications and immunomodulators.
本研究的目的是确定儿童自限性局灶性癫痫（SeLFE）脑电图（EEG）中的睡眠假性棘波-慢波激活（SWAS）模式，并研究其临床和电活动演变。我们从脑电图数据库中回顾性收集了2至12岁患有SeLFE和假性SWAS的儿童的睡眠脑电图和临床数据，并每6个月定期进行临床、脑电图和神经认知评估。共确定了9名儿童，并将其分为以下几组：（a）5名儿童由1型枕额棘波引起的假性SWAS模式，随访期间临床无恶化，该模式在3年内消失；（b）3名儿童无枕额棘波的假性SWAS模式，由先前存在的局灶性棘波扩散引起；（c）1名儿童由抗癫痫药物诱发的假性SWAS模式，停药后完全消失。假性SWAS中出现了电-临床分离，且均未演变为伴有SWAS的发育性和/或癫痫性脑病。识别这些模式有助于避免无意中使用抗癫痫药物和免疫调节剂。
