Spikes might precede seizures and predict epilepsy in children with Sturge-Weber syndrome: A pilot study

Epilepsy Res. 2018 Jul:143:75-78. doi: 10.1016/j.eplepsyres.2018.03.020. Epub 2018 Mar 28.

Abstract

Purpose: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder characterized by a facial port-wine stain, a glaucoma, and a leptomeningeal angioma. Epilepsy occurs in more than 75% of affected children, and seizures occurring in the first year of life are associated with a poor neurological prognosis. The aim of this study was to identify possible predictive markers of epilepsy on electroencephalogram (EEG) performed prior to seizure onset in children with SWS.

Methods: This study included children with a diagnosis of SWS who had an EEG performed prior to seizure onset. Patients who did not develop epilepsy had a minimum follow-up of 3-years. We compared EEG characteristics of patients who developed epilepsy with patients who did not develop epilepsy by the time of their follow-up.

Results: Eleven children were included in this study. EEG was performed at the median age of 2.1 months (range 1.0-22.1). Six children developed seizures with a time interval between EEG and seizure onset ranging from 2 days to 21 months. EEG background activity was asymmetric in 8 patients, 5 of whom later developed epilepsy. Focal interictal spikes or sharp waves were exclusively recorded in patients who developed later epilepsy (4 out of 6). One of these patients had a supposed false positive EEG as he did not developed epilepsy until 21 months later and one patient had a false negative EEG with seizures occurring 2 days after a normal EEG.

Conclusion: Spikes on EEG might be a useful marker to identify patients with SWS at risk of developing epilepsy. Their predictive value should be assessed in larger prospective studies.

Keywords: Children; EEG; Epilepsy; Seizures; Spikes; Sturge-Weber.

Publication types

  • Observational Study

MeSH terms

  • Brain / physiopathology*
  • Electroencephalography*
  • Epilepsy / diagnosis*
  • Epilepsy / physiopathology
  • Female
  • Follow-Up Studies
  • Functional Laterality
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Pilot Projects
  • Prognosis
  • Seizures / diagnosis*
  • Seizures / physiopathology
  • Sturge-Weber Syndrome / diagnosis*
  • Sturge-Weber Syndrome / physiopathology