title: [Study on concordance of ictal and interictal epileptiform activity in patients with tuberous sclerosis complex].
abstract: OBJECTIVE
  To analyze the relationship between the ictal onset zone and dominant interictal epileptiform foci in tuberous sclerosis complex (TSC) patients.
  
  
  METHODS
  Clinical data of 20 patients with TSC which had epileptic seizures during Video-EEG monitoring was assessed. Consistency and dominance of focal interictal epileptiform activity and the ictal onset zone were identified. Concordance between interictal and ictal findings was analyzed.
  
  
  RESULTS
  Of the 20 patients, 7 were female, and 13 were male. The age of epilepsy onset was from 15 d to 6 years. The Video-EEG monitoring age was from 6 months to 11 years. Family history was found in three cases. Abnormality in neuroimaging existed in 17 of 18 patients who were examined. Interictal EEG showed hypsarrhythmia in 3 patients, multifocal epileptiform activity with a dominant focus in 12 patients, both focal and generalized discharges in 2 patients, and only focal discharges in 3 patients. The seizures types during EEG monitoring included epileptic spasms, partial seizure, atypical absence, and generalized or focal myoclonic seizure. The most common seizure type was partial seizure and then epileptic spasms. EEG in 4 patients with epileptic spasms showed ictal generalized discharges and interictal hypsarrhythmia or generalized discharges. Clinical manifestation of epileptic spasms was asymmetric in 3 patients. Lateralization and location of interictal and ictal discharges were consistent in 2 of the 3 patients, while only lateralization consistency in 1 of the 3 patients. Partial seizures as the only seizure type were monitored in 13 patients. Of the 13 patients, lateralization and location of interictal and ictal discharges were inconsistent in 2 patients (15%), consistent in 8 patients (62%), lateralization or location consistent in 2 patients (15%). One case could not be analyzed because of uncertainty of lateralization and location of seizure onset.
  
  
  CONCLUSIONS
  In the majority of patients with TSC, multifocal interictal epileptiform activity is present, in which a most dominance of focal epileptiform activity could be found. For some epileptic seizures or the majority of partial seizures, the ictal onset zone is concordant with the dominance of focal interictal epileptiform foci. The concordance might have positioning reference significance for preoperative evaluation of epilepsy surgery.
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing.
authors.forename: Zhixian
authors.initials: Z
authors.lastname: Yang
authors.forename: Qinghui
authors.initials: Q
authors.lastname: Guo
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Zhuang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Xiong
authors.forename: Ye
authors.initials: Y
authors.lastname: Wu
authors.forename: Shuang
authors.initials: S
authors.lastname: Wang
authors.forename: Xingzhi
authors.initials: X
authors.lastname: Chang
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xinhua
authors.initials: X
authors.lastname: Bao
authors.forename: Yuwu
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Email: qinjiong@gmail.com.
authors.forename: Jiong
authors.initials: J
authors.lastname: Qin
mesh_terms: D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014402:Tuberous Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology