Academic Journal
Progressive slowing of clonic phase predicts postictal generalized EEG suppression
| Title: | Progressive slowing of clonic phase predicts postictal generalized EEG suppression |
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| Authors: | Maria Vlachou, Philippe Ryvlin, Anca Adriana Arbune, Sidsel Armand Larsen, Annette Skræp Sidaros, Melita Cacic Hribljan, Martin Fabricius, Sándor Beniczky |
| Source: | Epilepsia Epilepsia, vol. 63, no. 12, pp. 3204-3211 Vlachou, M, Ryvlin, P, Arbune, A A, Armand Larsen, S, Skræp Sidaros, A, Cacic Hribljan, M, Fabricius, M & Beniczky, S 2022, 'Progressive slowing of clonic phase predicts postictal generalized EEG suppression', Epilepsia, vol. 63, no. 12, pp. 3204-3211. https://doi.org/10.1111/epi.17434 Vlachou, M, Ryvlin, P, Arbune, A A, Armand Larsen, S, Skræp Sidaros, A, Cacic Hribljan, M, Fabricius, M & Beniczky, S 2022, ' Progressive slowing of clonic phase predicts postictal generalized EEG suppression ', Epilepsia, vol. 63, no. 12, pp. 3204-3211 . https://doi.org/10.1111/epi.17434 Vlachou, M, Ryvlin, P, Arbune, A A, Armand Larsen, S, Skærp Sidaros, A, Hribljan, M C, Fabricius, M & Beniczky, S 2022, ' Progressive slowing of clonic phase predicts postictal generalized EEG suppression ', 5th Annual Research Meeting, Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark, 24/11/2022-24/11/2022 . |
| Publisher Information: | Wiley, 2022. |
| Publication Year: | 2022 |
| Subject Terms: | Adult, Adolescent, Middle Aged, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Seizures/diagnosis, Humans, Female, Child, Seizures, Research Articles |
| Description: | ObjectivePostictal generalized electroencephalography (EEG) suppression (PGES) is a surrogate marker of sudden unexpected death in epilepsy (SUDEP). It is still unclear which ictal phenomena lead to prolonged PGES and increased risk of SUDEP. Semiology features of generalized convulsive seizure (GCS type 1) have been reported as a predictor of prolonged PGES. Progressive slowing of clonic phase (PSCP) has been observed in GCSs, with gradually increasing inhibitory periods interrupting the tonic contractions. We hypothesized that PSCP is associated with prolonged PGES.MethodsWe analyzed 90 bilateral convulsive seizures in 50 consecutive patients (21 female; age: 11–62 years, median: 31 years) recruited to video‐EEG monitoring. Five raters, blinded to all other data, independently assessed the presence of PSCP. PGES and seizure semiology were evaluated independently. We determined inter‐rater agreement (IRA) for the presence of PSCP, and we evaluated its association, as well as that of other ictal features, with the occurrence of PGES, prolonged PGES (≥20 s) and very prolonged PGES (≥50 s) using multivariate logistic regression analysis.ResultsWe found substantial IRA for the presence of PSCP (percent agreement: 80%; beyond‐chance agreement coefficient: .655). PSCP was an independent predictor of the occurrence of PGES and prolonged PGES (p p = .02) and prolonged PGES (p = .03) but not of very prolonged PGES. Only half of the seizures with very prolonged PGES were GCS type 1.SignificancePSCP predicts prolonged PGES, emphasizing the importance of gradually increasing inhibitory phenomena at the end of the seizures. Our findings shed more light on the ictal phenomena leading to increased risk of SUDEP. These phenomena may provide basis for algorithms implemented into wearable devices for identifying GCS with increased risk of SUDEP. |
| Document Type: | Article Other literature type Conference object |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1528-1167 0013-9580 |
| DOI: | 10.1111/epi.17434 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/36208032 https://serval.unil.ch/resource/serval:BIB_E5B1C7BD3C23.P001/REF.pdf https://serval.unil.ch/notice/serval:BIB_E5B1C7BD3C23 http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_E5B1C7BD3C238 https://pure.au.dk/portal/en/publications/7c4761ee-6efc-4818-84de-80532f8c80de https://curis.ku.dk/ws/files/334005883/Epilepsia_2022_Vlachou_Progressive_slowing_of_clonic_phase_predicts_postictal_generalized_EEG_suppression.pdf https://pure.au.dk/portal/en/publications/4e8f97e4-7589-447a-85ef-4eb09c2ed7b2 |
| Rights: | CC BY NC ND URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
| Accession Number: | edsair.doi.dedup.....a573c7e5f10d3d2b8c2db135b6dfaea7 |
| Database: | OpenAIRE |
| ISSN: | 15281167 00139580 |
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| DOI: | 10.1111/epi.17434 |