Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies

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...

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Main Authors: Neetha Balaram, Smita Balachandran, Abdul V Gafoor, SR Ratheesh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Annals of Indian Academy of Neurology
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Online Access:https://journals.lww.com/10.4103/aian.aian_899_24
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author Neetha Balaram
Smita Balachandran
Abdul V Gafoor
SR Ratheesh
author_facet Neetha Balaram
Smita Balachandran
Abdul V Gafoor
SR Ratheesh
author_sort Neetha Balaram
collection DOAJ
description 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.
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1998-3549
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spelling doaj-art-d3bf31b8abd64d6d8bff78f9bf2f178b2025-08-20T02:43:57ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492025-05-0128342643110.4103/aian.aian_899_24Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood EpilepsiesNeetha BalaramSmita BalachandranAbdul V GafoorSR RatheeshThe 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.https://journals.lww.com/10.4103/aian.aian_899_24pseudo-swasseleasselfetype 1 occipitofrontal spikes
spellingShingle Neetha Balaram
Smita Balachandran
Abdul V Gafoor
SR Ratheesh
Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
Annals of Indian Academy of Neurology
pseudo-swas
seleas
selfe
type 1 occipitofrontal spikes
title Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
title_full Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
title_fullStr Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
title_full_unstemmed Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
title_short Clinical and Electrical Evolution of “Pseudo” Spike–Wave Activation in Sleep EEG Patterns in Self-Limited Childhood Epilepsies
title_sort clinical and electrical evolution of pseudo spike wave activation in sleep eeg patterns in self limited childhood epilepsies
topic pseudo-swas
seleas
selfe
type 1 occipitofrontal spikes
url https://journals.lww.com/10.4103/aian.aian_899_24
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AT abdulvgafoor clinicalandelectricalevolutionofpseudospikewaveactivationinsleepeegpatternsinselflimitedchildhoodepilepsies
AT srratheesh clinicalandelectricalevolutionofpseudospikewaveactivationinsleepeegpatternsinselflimitedchildhoodepilepsies