title: Intracranially recorded interictal spikes: relation to seizure onset area and effect of medication and time of day.
abstract: OBJECTIVE
  The relationship between seizures and interictal spikes remains undetermined. We analyzed intracranial EEG (icEEG) recordings to examine the relationship between the seizure onset area and interictal spikes.
  
  
  METHODS
  80 unselected patients were placed into 5 temporal, 4 extratemporal, and one unlocalized groups based on the location of the seizure onset area. We studied 4-h icEEG epochs, removed from seizures, from day-time and night-time during both on- and off-medication periods. Spikes were detected automatically from electrode contacts sampling the hemisphere ipsilateral to the seizure onset area.
  
  
  RESULTS
  There was a widespread occurrence of spikes over the hemisphere ipsilateral to the seizure onset area. The spatial distributions of spike rates for the different patient groups were different (p<0.0001, chi-square test). The area with the highest spike rate coincided with the seizure onset area only in half of the patients.
  
  
  CONCLUSIONS
  The spatial distribution of spike rates is strongly associated with the location of the seizure onset area, suggesting the presence of a distributed spike generation network, which is related to the seizure onset area.
  
  
  CONCLUSIONS
  The spatial distribution of spike rates, but not the area with the highest spike rate, may hold value for the localization of the seizure onset area.
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA. Electronic address: Irina.Goncharova@yale.edu.
authors.forename: Irina I
authors.initials: II
authors.lastname: Goncharova
authors.forename: Susan S
authors.initials: SS
authors.lastname: Spencer
authors.forename: Robert B
authors.initials: RB
authors.lastname: Duckrow
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Hirsch
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Spencer
authors.forename: Hitten P
authors.initials: HP
authors.lastname: Zaveri
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000927:Anticonvulsants / Q000627:therapeutic use; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D002909:Chronobiology Phenomena; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064926:Neurophysiological Monitoring; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D058067:Wavelet Analysis; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Intracranial monitoring; Neocortical epilepsy; Seizure onset area; Sleep; Temporal lobe epilepsy; Wake