title: Focal epileptiform spikes in conjuction with K-complexes.
abstract: Dyshormia or epileptiform spikes occurring within K-complexes have been described in patients with generalized epilepsy, with one study reporting that generalized spikes occurred frequently in association with K-complexes. We report the rate of focal epileptiform spikes occurring within K-complexes in localization-related epilepsy. Presurgical or diagnostic long-term video-EEG results of 40 consecutive patients with epilepsy (13 patients with right temporal lobe epilepsy, 20 patients with left temporal lobe epilepsy, and 7 patients with frontal lobe epilepsy) were reviewed. Sleep samples were reviewed and the numbers of K-complexes, spikes, and spikes within K-complexes were recorded. The comparison group consisted of 40 consecutive patients with nonepileptic events who were monitored with long-term video EEG. Focal epileptiform spikes occurring within K-complexes occurred in 2 of 13 (15%) patients with right temporal lobe patients, 6 of 20 (30%) patients with left temporal lobe, and 3 of 7 (42%) patients with extratemporal lobe epilepsy. In most patients, spikes occurring during K-complexes were rare. We identified spikes occurring during K-complexes in patients with localization-related epilepsy. The sharply contoured components of K-complexes or associated sleep spindles may obscure focal spikes within K-complexes. Nevertheless, K-complexes may be associated with focal epileptiform discharges.
authors.affiliation: The Sleep Program, The Clinical Neurophysiology Laboratories, Southern Sleep Specialists, Alabama 35406, USA. geyermd@bellsouth.net
authors.forename: James D
authors.initials: JD
authors.lastname: Geyer
authors.forename: Paul R
authors.initials: PR
authors.lastname: Carney
authors.forename: Frank
authors.initials: F
authors.lastname: Gilliam
mesh_terms: D000293:Adolescent; D000328:Adult; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013702:Temporal Lobe / Q000503:physiopathology*; D014743:Videotape Recording