The topographical distribution of epileptic spikes in juvenile myoclonic epilepsy with and without photosensitivity

Clin Neurophysiol. 2017 Jan;128(1):176-182. doi: 10.1016/j.clinph.2016.10.098. Epub 2016 Nov 14.

Abstract

Objective: Up to 30% of people with juvenile myoclonic epilepsy (JME) have photoparoxysmal responses (PPR). Recent studies report on structural and pathophysiological differences between people with JME with (JME+PPR) and without PPR (JME-PPR). We investigated whether electrophysiological features outside photic stimulation differ between these subtypes.

Methods: We analysed EEG recordings of people with JME at a tertiary epilepsy centre and an academic hospital. Photosensitivity was assessed in a drug-naïve condition. We compared the occurrence and involvement of posterior electrodes for focal abnormalities and generalised spike-wave activity in the EEG outside photic stimulation between JME+PPR and JME-PPR.

Results: We included EEG recordings of 18 people with JME+PPR and 21 with JME-PPR. People with JME-PPR had less focal abnormalities in the posterior brain regions than people with JME+PPR (19% vs 55%, p<0.05). There was no difference in the distribution of generalised spike-wave activity between people with JME+PPR and JME-PPR.

Conclusion: This study demonstrates electrophysiological correlates of the previously described structural and physiological differences between JME+PPR and JME-PPR.

Significance: Findings support the hypothesis that posterior interictal EEG abnormalities reflect localised cortical hyperexcitability, which makes patients with JME more sensitive to photic stimuli.

Keywords: Electroencephalography; Interictal discharges; Intermittent photic stimulation; Juvenile myoclonic epilepsy; Photosensitivity.

Publication types

  • Comparative Study

MeSH terms

  • Action Potentials* / physiology
  • Adolescent
  • Adult
  • Brain Mapping / methods*
  • Child
  • Electroencephalography / methods*
  • Epilepsy, Reflex / diagnosis
  • Epilepsy, Reflex / physiopathology*
  • Female
  • Humans
  • Male
  • Myoclonic Epilepsy, Juvenile / diagnosis
  • Myoclonic Epilepsy, Juvenile / physiopathology*
  • Photic Stimulation / methods*
  • Young Adult