Focal Spikes Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Focal Spikes,

Negated

None

Unsure

None

Possible Causes

Hashimoto Thyroiditis

Hashimoto’s thyroiditis is an inflammatory disorder which is autoimmune in origin. It is also known as chronic autoimmune thyroiditis, as lymphocytic infiltration is seen in the thyroid. Hurthle cell formation is also seen. Generally it is asymptomatic in mild and moderate disease conditions but the symptoms are noticeable[…] [symptoma.com]

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Epilepsy

Focal seizures began at 5 years and were refractory to medical treatment. [ncbi.nlm.nih.gov]

(EEG) hallmark of focal-onset seizures is the focal interictal epileptiform spike or sharp wave. [emedicine.medscape.com]

At 9 years, video EEG monitoring showed a striking pattern of interictal slow spike-wave and paroxysmal fast activity, maximal over the right, initially unaffected, hemisphere [ncbi.nlm.nih.gov]

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Juvenile Myoclonic Epilepsy

Abstract This chapter covers the syndromes of benign epilepsy with centrotemporal spikes (BECTS), nonlesional focal epilepsy in otherwise normal children (NLFN), and the genetic [ncbi.nlm.nih.gov]

We compared the occurrence and involvement of posterior electrodes for focal abnormalities and generalised spike-wave activity in the EEG outside photic stimulation between [ncbi.nlm.nih.gov]

[…] discharges on electroencephalography, and a lack of focal abnormality on magnetic resonance imaging (MRI). [ncbi.nlm.nih.gov]

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Generalized Clonic or Tonic-Clonic Seizures

Generalized spiking is usually large and obvious, while focal spikes (especially temporal lobe spiking) may be smaller and more subtle to see. [hawaii.edu]

Ictal EEG in focal seizures consisted of spikes (66%) or rhythmic theta-alpha activity (33%) in tonic-clonic seizures with secondary generalization; rhythmic spikes (73%), [scielo.br]

Localization-related (focal, local, partial) epilepsies and syndromes 1.1. Idiopathic with age-related onset A. Benign childhood epilepsy with centrotemporal spikes B. [liveto.com]

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Childhood Absence Epilepsy

PURPOSE: To better understand the nature of the focal spike-wave discharges (FSWDs) and focally led generalized spike-wave discharges (GSWDs) in typical childhood absence [ncbi.nlm.nih.gov]

Abstract The EEG in childhood absence epilepsy (CAE) may contain focal and generalised spike-wave discharges (SWDs) with focal, mainly frontal, "lead-in". [ncbi.nlm.nih.gov]

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Benign Adult Familial Myoclonic Epilepsy

 Previously called early-benign childhood seizures with occipital spikes  Childhood onset (peak 5 years).  Focal autonomic seizures or autonomic status epilepticus, frequently [slideshare.net]

[…] development Developmental regression Generalized hypotonia Epileptic spasms Babinski sign Cutaneous photosensitivity Hypomimic face Hand tremor Generalized-onset seizure Focal [mendelian.co]

According to Cantello et al., 55 focal subcortical reflex myoclonus can also be demonstrated in these patients. [clinicalgate.com]

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West Syndrome

Brain MRI revealed no abnormal findings although interictal EEG demonstrated left centro-parieto-temporal localized spike foci. [ncbi.nlm.nih.gov]

A “leading” spike had a focal origin in all 42 type I spasms and involved the pre‐ or postcentral gyrus within 0.1 s in 37 of these spasms. [doi.org]

At time they appear to be focal, and a few seconds later they seem to originate from multiple foci. [en.wikipedia.org]

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Idiopathic Generalized Epilepsy

Fragmented generalized spike-and-wave can appear focal or multi-focal but usually is not consistently seen in 1 area. [medlink.com]

The interictal EEG showed generalized spike-and-wave alone in 8 patients, focal or multifocal spike-and-wave alone in 3 patients, both generalized and focal spike-and-wave [nature.com]

The morphology of the focal spike-and-wave typically appears similar to the generalized spike-and-wave. Ictal. [medlink.com]

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Juvenile Absence Epilepsy

Although focal spikes can occur, if they consistently arise in 1 area, consider structural brain abnormality. Caution. If slow spike-and-wave ( Imaging. [medlink.com]

Previous clinical and EEG studies show a relationship between generalized and focal spike–wave discharges in some situations. [academic.oup.com]

Interictal and ictal EEG is characterized by focal generalized spike-wave discharge occasionally prominent in the frontal region. [1pdf.net]

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Encephalopathy

*Frontal dominance (FIRDA) --non specific ,diffuse encephalopathy, if focal ? [slideshare.net]

[…] of periodic lateralized epileptiform discharges (PLEDS).[37] In hypokalemia, diffuse slow activity can be seen together with paroxysmal delta/theta activity, as well as focal [neurologyindia.com]

*Repetitive and fairly stereotyped waveforms appearing at regular intervals, sharps/spike waves or complex discharges. [slideshare.net]

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Uremic Encephalopathy

[…] paroxysms of sharp waves and spike-waves during hyperventilation (HV). [38] In patients with cirrhosis, in addition to diffuse slow activity (theta and delta), triphasic [neurologyindia.com]

[…] of periodic lateralized epileptiform discharges (PLEDS). [37] In hypokalemia, diffuse slow activity can be seen together with paroxysmal delta/theta activity, as well as focal [neurologyindia.com]

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Organic Brain Syndrome

Rogers MP, et al. Psychosom Med. 1986 Jul-Aug. Abstract Systemic mastocytosis is a disease characterized by an excessive accumulation of mast cells, and associated with skin lesions, flushing, diarrhea, tachycardia, and psychiatric manifestations. In order to define more clearly the psychiatric manifestations, ten[…] [ncbi.nlm.nih.gov]

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Neonatal Seizures

spike discharges in infancy. [ncbi.nlm.nih.gov]

In birth injury or cerebral anoxia, EEG mostly revealed focal-unilateral abnormality or suppression-burst activity in newborns and hypsarhythmia or focal features in infants [ncbi.nlm.nih.gov]

[…] infantile convulsion or breath-holding spell. 6) EEG features of cerebral malformation were asymmetrical or multifocal dischages in neonatal period and hypsarhythmia or focal-unilateral [ncbi.nlm.nih.gov]

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Myoclonic-Astatic Epilepsy

In contrast, all cases with a poor prognosis had focal spike discharges. [ncbi.nlm.nih.gov]

or polyspike-wave EEG discharges at 2-3 Hz, without focal spike discharges; and (4) exclusion of severe and benign myoclonic epilepsy (SME, BME) in infants and cryptogenic [ncbi.nlm.nih.gov]

Early onset and focal spike discharges as indicators of poor prognosis for myoclonic-astatic epilepsy. Brain Dev. 2014 Aug;36(7):613-9. [pediatricfocus.wordpress.com]

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Toxic Encephalopathy

[…] paroxysms of sharp waves and spike-waves during hyperventilation (HV). [38] In patients with cirrhosis, in addition to diffuse slow activity (theta and delta), triphasic [neurologyindia.com]

[…] of periodic lateralized epileptiform discharges (PLEDS). [37] In hypokalemia, diffuse slow activity can be seen together with paroxysmal delta/theta activity, as well as focal [neurologyindia.com]

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Panayiotopoulos Syndrome

In three, in addition to the diffuse paroxysms, focal spikes appeared later. From a clinical point of view, other features were otherwise unremarkable. [ncbi.nlm.nih.gov]

spikes. [ncbi.nlm.nih.gov]

Abstract Focal spike activities in Panayiotopoulos syndrome involve all brain regions in electroencephalography, and commonly reveal multiple foci, often through occipital [ncbi.nlm.nih.gov]

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Epilepsy with Continuous Spike-and-Slow-Waves during Sleep

Awake EEG record, showed bilateral spike and wave discharges in the frequency of 2 to 3Hz and also showed some focal spikes predominantly in right frontal area ( Fig. 1 ). [indianpediatrics.net]

A sleep EEG recording showed focal spike and wave discharges over the right central and temporal leads (C4-T4). [intechopen.com]

[…] and waves during sleep p. 137 Late onset acquired epileptic aphasia p. 143 CSWS: SW index value according to the slow sleep stages p. 149 Continuous focal discharges during [booktopia.com.au]

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Hypoparathyroidism

Although glucocorticoids have a known negative effect on calcium balance, they do not normally cause clinically significant hypocalcaemia. A young woman with post-surgical hypoparathyroidism developed symptomatic hypocalcaemia on two occasions following treatment with intravenous hydrocortisone for allergic reactions.[…] [ncbi.nlm.nih.gov]

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Early Infantile Epileptic Encephalopathy Type 3

 I stage is before the discovery of CSWS  The EEG shows multi-focal spikes and bisynchronous generalised sharp or spike-wave discharges.  II stage is when CSWS is found [slideshare.net]

[…] with centrotemporal EEG spikes Childhood epilepsy with occipital EEG paroxysms G40.1 Localization-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with [apps.who.int]

[…] wave 6 (16.2) Focal epileptiform discharges 2 (5.4) * Others: Agenesis of corpus callosum, arachnoid cyst, hemiatrophy, delayed myelination and posterior falcine bleed in [indianpediatrics.net]

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Lennox-Gastaut Syndrome

Interictal There may be focal or multifocal spike-and-wave or sharp-slow waves, with an anterior predominance. [epilepsydiagnosis.org]

In LGS, major seizures are mainly atypical absences and tonic seizures with 0.5-2Hz slow spike-waves and eventually focal anomalies. [ncbi.nlm.nih.gov]

[…] discharges and in 5 (20.9%) of them the spike-wave complexes were not generalized but focal. [omicsonline.org]

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Insulin Overdose

We report a very rare case of acute pulmonary edema caused by hypoglycemia from insulin overdose during an attempted suicide. A 16-year-old woman with type 1 diabetes was brought to our hospital because of hypoglycemic coma. She exhibited severe hypoxia; upon intubation, bloody froth poured out of the tube.[…] [ncbi.nlm.nih.gov]

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Hypoxic-Ischemic Brain Injury

Interictal The interictal EEG may be normal or may show focal or multi-focal interictal spikes or spike-and-wave over the location(s) of the brain injury. [epilepsydiagnosis.org]

Dysfunctions probably located in the brainstem and diencephalon, or in their non specific projections, would explain the coexistence of spike and wave activity and OIRDA in [scielo.br]

Multi-focal independent spikes or generalized spike-and-wave (usually 3 Hz) can be seen in young patients who evolve to have generalized seizure types. [epilepsydiagnosis.org]

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Rolandic Epilepsy

Focal spikes and sharp waves with predominantly centrotemporal localization are the electroencephalograhic hallmark of Rolandic epilepsy (or BECTS). [ncbi.nlm.nih.gov]

So the EEG typically shows dramatic focal spikes in the centrotemporal region of brain. [chp.edu]

focal or generalized spikes and waves. [ncbi.nlm.nih.gov]

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Focal Epilepsy - Speech Disorder - Mental Retardation

Uni-Focal Spikes Can be due to superficial or deep cortical or thalamic lesions. [studystack.com]

 I stage is before the discovery of CSWS  The EEG shows multi-focal spikes and bisynchronous generalised sharp or spike-wave discharges.  II stage is when CSWS is found [slideshare.net]

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Benign Familial Infantile Epilepsy Type 4

DeMarco, P., and Negrin, P., Parietal focal spikes evoked by contralateral tactile somatotopic stimulation in four non-epileptic subjects, Electroenceph. clin. [journals.sagepub.com]

Epilepsies Genetic Generalized Epilepsies—Epilepsies With Generalized Spike–Waves Chapter 17: Myoclonic Epilepsy in Infancy and Epilepsy With Myoclonic Atonic Seizures Chapter [connect.springerpub.com]

[…] the EEG showed low voltage undifferentiated activity with frequent ictal pattern and occasional focal spikes and sharp waves. [karger.com]

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Progressive Myoclonic Epilepsy Type 3

EEG: Generalized almost symmetrical high-voltage polyspikes-and-wave along with frequent bilateral independent posterior dominant (T6, O2//T5, O1) focal spikes on a slow & [pubs.sciepub.com]

EEG revealed abundant generalized almost symmetrical high-voltage polyspike-and-wave along with frequent bilateral independent posterior dominant (T6, O2//T5, O1) focal spikes [pubs.sciepub.com]

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Benign Prostatic Hyperplasia

Benign childhood epilepsy with centrotemporal spikes (BECTS) is a type of focal idiopathic epilepsy more common in childhood. [scielo.br]

[…] with midline spikes and waves during sleep (BIMSE) (see these terms). [orpha.net]

Benign partial epilepsy in childhood: Selective cognitive deficits are related to the location of focal spikes determined by combined EEG/MEG. [scielo.br]

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Cardiogenic Syncope

A standard EEG showed focal spike and wave with delta slowing on the right centrotemporal region (C4-T4). [jnnp.bmj.com]

[…] or general spike activity Responsive to AEDs No Often Short term mortality† High Low RE-EVALUATION OF AN EPILEPSY DIAGNOSIS Three studies, involving altogether 101 patients [ncbi.nlm.nih.gov]

[…] consciousness Typical Common Episode duration Seconds Minutes Involuntary movements Common Typical Amnesia Yes Yes Arrhythmia Common Rare* Electroencephalogram Slow waves Flattening Focal [ncbi.nlm.nih.gov]

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Streptococcus Pyogenes

However, spikes fever persisted over 2 days. [indianpediatrics.net]

Initial chest radiography showed focal parenchymal consolidations over the right upper lobe. We prescribed empiric antibiotics with cefuroxime and azithromycin at first. [indianpediatrics.net]

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Familial Infantile Myoclonic Epilepsy

[…] the EEG showed low voltage undifferentiated activity with frequent ictal pattern and occasional focal spikes and sharp waves. [karger.com]

Called benign infantile focal epilepsy with midline spikes and waves during sleep, these infants have few seizures and there may often be a family history.[2] References[edit [en.wikipedia.org]

[…] with midline spikes and waves during sleep (BIMSE) (see these terms). [rarediseases.info.nih.gov]

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