title: Postictal generalized EEG suppression after generalized convulsive seizures: A double-edged sword.
abstract: OBJECTIVE
  The aim of this study is to investigate the key facilitating factors for postictal generalized EEG suppression (PGES) in a large cohort of patients with generalized convulsive seizures (GCSs).
  
  
  METHODS
  We retrospectively reviewed the data of consecutive patients who had GCSs in the epilepsy monitoring units of two epilepsy centers. Statistical analysis was performed to assess specific variables as potential risk factors for PGES.
  
  
  RESULTS
  Among the 208 enrolled patients with 366 seizures, PGES was observed in 109 (51.9%) patients and 168 (45.9%) GCSs. The mean duration of PGES was 33.2 ± 12.0 s (34 s, 3-70 s). PGES or severe PGES (>20 s) was associated with more severe postictal coma and temporal lobe epilepsy. Moreover, PGES was independently associated with a longer tonic duration, shorter total seizure duration, and lower habitual seizure frequency.
  
  
  CONCLUSIONS
  PGES is strongly correlated not only with longer tonic duration, but also with shorter total seizure duration and lower habitual seizure frequency.
  
  
  CONCLUSIONS
  PGES may represent a switch-off inhibitory mechanism in seizure termination; moreover, it may indicate the efficacy of a long-lasting inhibitory network that suppresses GCS ictogenesis.
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Jiahui
authors: J
authors: Xu
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Bo
authors: B
authors: Jin
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Jianwei
authors: J
authors: Yan
authors: Department of Neurology, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
authors: Jing
authors: J
authors: Wang
authors: Department of Neurology, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
authors: Jingying
authors: J
authors: Hu
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Zhongjin
authors: Z
authors: Wang
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China and Zhejiang Province Key Laboratory of Neurobiology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.
authors: Zhong
authors: Z
authors: Chen
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Meiping
authors: M
authors: Ding
authors: Department of Neurology, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China. Electronic address: Shuangwang1977@gmail.com.
authors: Shuhua
authors: S
authors: Chen
authors: Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China and Zhejiang Province Key Laboratory of Neurobiology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China. Electronic address: sayflower@126.com.
authors: Shuang
authors: S
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004576:Electromyography / Q000379:methods; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult
keywords: Epilepsy; Epilepsy semiology; Generalized convulsive seizures; Postictal generalized EEG suppression; Temporal lobe epilepsy