Difference between revisions of "Postictal generalized electroencephalographic suppression is associated with generalized seizures"

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A major proposed mechanism of SUDEP is the concept of electro-cerebral shutdown, seen on scalp EEG as prolonged post-ictal generalized EEG suppression (PGES). Lhatoo et al reports that prolonged PGES (>50 seconds) appears to identify refractory epilepsy patients who are at risk of SUDEP and risk of SUDEP may be increased in direct proportion to duration of PGES. This study by Surges failed to reproduce such findings. In fact There seems to be intraindividual variability in both the occurrence and duration of PGES after seizures. For instance, this study reported that PGES was observed after one seizure out of six in one individual and after all four seizures in another with the duration varying from 63 to 128 seconds. In addition, the level of inconsistency increased with the number of seizures recorded from any one individual [[
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A major proposed mechanism of SUDEP is the concept of electro-cerebral shutdown, seen on scalp EEG as prolonged post-ictal generalized EEG suppression (PGES). Lhatoo et al reports that prolonged PGES (>50 seconds) appears to identify refractory epilepsy patients who are at risk of SUDEP and risk of SUDEP may be increased in direct proportion to duration of PGES. This study by Surges failed to reproduce such findings. In fact There seems to be intraindividual variability in both the occurrence and duration of PGES after seizures. For instance, this study reported that PGES was observed after one seizure out of six in one individual and after all four seizures in another with the duration varying from 63 to 128 seconds. In addition, the level of inconsistency increased with the number of seizures recorded from any one individual [[Postictal_generalized_EEG_suppression:_an_inconsistent_finding_in_people_with_multiple_seizures|see Lamberts et al 2013]]
 
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The evidence has been inconsistent in determining the role of PGES in SUDEP.
the evidence has been inconsistent in determining the role played by PGES in SUDEP [[Postictal_generalized_electroencephalographic_suppression_is_associated_with_generalized_seizures|See PGES is associated with generalized seizures by Surges ]]. PGES is seen most often after generalized tonic-clonic seizures, which is a well-known risk factor for SUDEP but it is not a consistent post-ictal finding.
 

Revision as of 12:41, 19 April 2018

A major proposed mechanism of SUDEP is the concept of electro-cerebral shutdown, seen on scalp EEG as prolonged post-ictal generalized EEG suppression (PGES). Lhatoo et al reports that prolonged PGES (>50 seconds) appears to identify refractory epilepsy patients who are at risk of SUDEP and risk of SUDEP may be increased in direct proportion to duration of PGES. This study by Surges failed to reproduce such findings. In fact There seems to be intraindividual variability in both the occurrence and duration of PGES after seizures. For instance, this study reported that PGES was observed after one seizure out of six in one individual and after all four seizures in another with the duration varying from 63 to 128 seconds. In addition, the level of inconsistency increased with the number of seizures recorded from any one individual see Lamberts et al 2013 The evidence has been inconsistent in determining the role of PGES in SUDEP.