Multifocal Spikes: Causes & Reasons

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Possible Causes for Multifocal Spikes

Developmental and Epileptic Encephalopathy Type 3

The EEG pattern often shows a suppression-burst pattern with high-voltage bursts of slow waves mixed with multifocal spikes alternating with isoelectric suppression phases [diseaseinfosearch.org]

West Syndrome (WS) aka as infantile spasms with hypsarrhythmia, EEG abnormality with asynchronous very high amplitude, irregular, continuous multifocal spike an slow wave [ijponline.biomedcentral.com]

Interictal EEGs of the patients with ZS showed infrequent bilateral multifocal spikes, predominantly in the frontal and pre-frontal motor cortex Patients with NALD had tonic [graphyonline.com]

West Syndrome

Interictal The background EEG is often highly disorganized with high voltage irregular slow waves intermixed with multifocal spikes and polyspikes, this is termed 'hypsarrhythmia [epilepsydiagnosis.org]

The interictal EEG pattern is described as hypsarrhythmic as it is characterised by asynchronous and high-amplitude slow waves and multifocal spikes. [orpha.net]

Myoclonic-Astatic Epilepsy

Interictal EEG revealed generalized irregular multiple spikes-and-waves with focal or multifocal accentuations. [ncbi.nlm.nih.gov]

LTG, lamotrigine; M, myoclonic seizure; MA, myoclonic-astatic seizure; MF, multifocal spikes; PHT, phenytoin; PSW, diffuse polyspike and wave complexes; SBA, slowing of [omicsonline.org]

[…] and waves, photosensitivity, 4-7/sec rhythms), no multifocal EEG abnormalities (but often pseudofoci). [ncbi.nlm.nih.gov]

Lennox-Gastaut Syndrome

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

Electroencephalogram (EEG) showed background slowing of about 7 Hz, multifocal spike and wave, and generalized spike and wave complex-es (1.5~3.5 Hz). [jkna.org]

The interictal EEG record was suggestive of multifocal spike-and-wave discharges in both hemispheres, particularly in the left frontocentral, right parieto-temporo-occipital [pediatricneurosciences.com]

Benign Adult Familial Myoclonic Epilepsy

Note the high-amplitude, disorganized slow activity with multifocal spikes with an electrodecremental response. [euroformhealthcare.biz]

Cortical myoclonus is more commonly encountered in a multifocal form, presenting with multifocal spike discharges. [neupsykey.com]

[…] with emesis.  Interictal EEG with shifting or multifocal high- amplitude spikes, often with occipital predominance.  Favorable outcome with remission in 1–2 years and normal [slideshare.net]

Epilepsy

[…] predominance, and multifocal spike-and-slow waves. [ncbi.nlm.nih.gov]

Electroencephalography showed multifocal spikes over the right frontal, temporal and parietal regions. The seizure frequency decreased dramatically after tumorectomy. [ncbi.nlm.nih.gov]

Inter-ictal multifocal spikes or sharp and slow waves in nearly all EEGs. [epilepsy.com]

Idiopathic Generalized Epilepsy

spikes and slow waves Ictal EEG: very heterogeneous First-line treatment: ACTH, prednisone, or vigabatrin Poor; increased mortality Neurodevelopmental delay, regression of [amboss.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]

[…] sharp and slow waves Abnormal interictal EEG: slow spike-wave pattern Attempt anticonvulsive treatment, e.g., valproic acid, clobazam, lamotrigine, felbamate [13] Ketogenic [amboss.com]

Developmental and Epileptic Encephalopathy Type 13

Diagnosis Hypsarrhythmia, the typical interictal EEG finding, consists of a disorganized pattern with asynchronous, very high amplitude slowing and frequent multifocal spike [intechopen.com]

Diagnosis The interictal EEG consists of multifocal epileptiform discharges and background slowing. [intechopen.com]

Ictal EEG recording may demonstrate generalized slow spike and wave, or an absence pattern, depending on the seizure type. 8.3. [intechopen.com]

Familial Progressive Myoclonic Epilepsy

Cortical myoclonus is more commonly encountered in a multifocal form, presenting with multifocal spike discharges. [neupsykey.com]

multifocal abnormalities. [neupsykey.com]

Paroxysmally, rhythmic θ-activity at 4 to 5 Hz appears in the centroparietal areas, as do fast bilateral spike-waves, which may be associated later with variable focal or [neupsykey.com]

Juvenile Myoclonic Epilepsy

Juvenile myoclonic epilepsy is a common form of epilepsy mainly characterized by myoclonic jerks, but affected individuals may also experience generalized tonic-clonic seizures and absence seizures. Symptom onset typically occurs around puberty and although the disease persists into adulthood, patients do respond[…] [symptoma.com]

Developmental and Epileptic Encephalopathy Type 17

Ohtahara syndrome (OS, OMIM#308350, ORPHA1934) is an early-onset epileptic encephalopathy (EOEE) characterised by spasms, intractable seizures, suppression-burst pattern on the electroencephalogram, and severe psychomotor retardation. Mutations in STXBP1 -a gene that codes for syntaxin binding protein 1 and is[…] [ncbi.nlm.nih.gov]

Organic Brain Syndrome

An organic brain syndrome ( OBS ), also known as an organic brain disease/disorder ( OBD ), an organic mental syndrome ( OMS ), or an organic mental disorder ( OMD ), is a syndrome or disorder of mental function whose cause is alleged to be known as organic ( physiologic ) rather than purely of the mind. These[…] [en.wikipedia.org]

Encephalopathy

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly[…] [ncbi.nlm.nih.gov]

Uremic Encephalopathy

BACKGROUND AND PURPOSE: Uremic encephalopathy is a metabolic disorder in patients with renal failure. The purpose of this study was to describe the MR imaging findings of uremic encephalopathy. MATERIALS AND METHODS: This study retrospectively reviewed MR imaging findings in 10 patients with clinically proved uremic[…] [ncbi.nlm.nih.gov]

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]

Toxic Encephalopathy

Neurotoxicity following paradichlorobenzene (PDCB) exposure is rare and can occur in patients with pica and mothball or toilet cake ingestion. We present a rare case of toxic encephalopathy due to PDCB mothball inhalation and ingestion and describe the rapidly progressive leukoencephalopathy seen on computed[…] [ncbi.nlm.nih.gov]

Hypoxic-Ischemic Brain Injury

Homepage Rare diseases Search Search for a rare disease Neonatal hypoxic and ischemic brain injury ORPHA:137577 Synonym(s): HIE Hypoxic and ischemic brain injury in the newborn Hypoxic-ischemic encephalopathy Perinatal asphyxia Perinatal hypoxia Prevalence: 1-9 / 100 000 Inheritance: Not applicable Age of onset:[…] [orpha.net]

Focal Epilepsy - Speech Disorder - Mental Retardation

Multifocal Spike and Wave is defined as "spikes in 3 non-contiguous electrode positions with at least one focus in each hemisphere" (Blume 1982). [pediatrics.emory.edu]

Note the high-amplitude, disorganized slow activity with multifocal spikes with an electrodecremental response. [euroformhealthcare.biz]

During the awake and light sleep states, the EEG was abnormal in most of the patients (9/ 11) with multifocal spikes. [scielo.br]

Progressive Myoclonic Epilepsy Type 8

[…] fast spikes, polyspikes and polyspike‐and‐wave discharges Slow background activity, spike‐ and polyspike‐and‐wave discharges and multifocal spikes activated by non‐REM sleep [onlinelibrary.wiley.com]

Slow background activity mixed with low‐voltage fast activity, along with diffuse, irregular, spike‐ and polyspike‐and‐wave discharges Slow background activity and multifocal [onlinelibrary.wiley.com]

spike and polyspike‐and‐wave discharges. [onlinelibrary.wiley.com]

Juvenile Absence Epilepsy

What is juvenile absence epilepsy like? Seizures in juvenile absence epilepsy (JAE) can be of two main types. Absence seizures are seen in all cases. In an absence seizure, the young person will stare and is either unresponsive or has impaired responsiveness. Their eyes may roll up briefly or the eyelids may flutter.[…] [epilepsy.com]

Blitz-Nick-Salaam Attacks

Typically, the interictal pattern is hypsarrhythmia (chaotic, high-voltage polymorphic delta and theta waves with superimposed multifocal spike discharges). [msdmanuals.com]

Pyridoxine Dependency Syndrome

Hypsarrhythmia is a characteristic interictal pattern of chaotic, high to extremely high-voltage polymorphic delta and theta rhythms with superimposed multifocal spikes and [patient.info]

[…] myoclonic Malignant migrating partial seizures of infancy Multifocal sharps Focal, arising from multiple regions Pyridoxine-dependent epilepsy Continuous spike-wave Burst [demosmedical.com]

Patients with West syndrome associated with HME may have a unique EEG background called hemihypsarrhythmia (high amplitude, poorly organized with multifocal spikes over the [demosmedical.com]

Lethal Neonatal Spasticity - Epileptic Encephalopathy

In nearly all cases, the backgrounds will be slowed and there will be multifocal spikes with variable morphology (pleomorphic multifocal spikes). [thoracickey.com]

On day 3, the interictal EEG showed multifocal spikes. [ng.neurology.org]

The EEG shows multifocal spikes with or without burst suppression. [thoracickey.com]

Developmental and Epileptic Encephalopathy Type 6

As seizures accumulate, however, multifocal spikes or spike and waves are encountered on EEG. [symptoma.com]

Among the 31 adult patients reported by Akiyama et al. (2010), 4 (12.9%) had generalized spike‐waves and multifocal spikes, 13 (41.9%) had multifocal spikes, 6 (19.3%) had [onlinelibrary.wiley.com]

During disease progression and increased seizure frequency, however, EEG findings eventually reveal both focal and multifocal anomalies, including generalized spike-and-wave [symptoma.com]

Developmental and Epileptic Encephalopathy Type 19

The interictal EEG shows disorganized high-amplitude slow background with multifocal spikes more pronounced during the sleep. [hindawi.com]

spikes. [mdpi.com]

Diagnosis Hypsarrhythmia, the typical interictal EEG finding, consists of a disorganized pattern with asynchronous, very high amplitude slowing and frequent multifocal spike [intechopen.com]

Developmental and Epileptic Encephalopathy Type 4

The EEG typically shows focal or multifocal spike-waves, sharp waves, and slow waves and spikes activity [88]. [ijponline.biomedcentral.com]

Diagnosis Hypsarrhythmia, the typical interictal EEG finding, consists of a disorganized pattern with asynchronous, very high amplitude slowing and frequent multifocal spike [intechopen.com]

Hypsarrhythmia, the typical interictal EEG finding, consists of a disorganized pattern with asynchronous, very high amplitude slowing and frequent multifocal spike and sharp [hindawi.com]

Infantile 3-Phosphoglycerate Dehydrogenase Deficiency

EEGs show background slowing with generalized spike-and-wave and mixed multifocal discharges [8, 14]. [hindawi.com]

Interictal EEGs of the patients with ZS showed infrequent bilateral multifocal spikes, predominantly in the frontal and pre-frontal motor cortex Patients with NALD had tonic [graphyonline.com]

Seizures are linked in most cases to lactic acidemia or hypoglycemia and are associated with multifocal spike-wave discharges on EEG [8]. [hindawi.com]

PEHO Syndrome

Multifocal spike waves and an abnormal background activity were seen on initial electroencephalography. There was, however, no clear ictal pattern. [ajnr.org]

Developmental and Epileptic Encephalopathy Type 26

The clinical features included infant-onset refractory seizures of multiple types, diffuse slow-wave EEG with multifocal spikes, global developmental delay, and hypotonia. [docksci.com]

Diagnosis Hypsarrhythmia, the typical interictal EEG finding, consists of a disorganized pattern with asynchronous, very high amplitude slowing and frequent multifocal spike [intechopen.com]

This is a goodexample of seizure and syndrome evolution in early infancy: acommon phenomenon.The interictal EEG shows diffuse slow background activityand multifocal spikes [docslide.com.br]

Developmental and Epileptic Encephalopathy Type 7

[…] wave in frontal regions Day 4: Normal, absence of any signal abnormality Patient 8 ND PHB, PHT 0-2 m: Bursts of multifocal spikes, periods of flatness. >2 m: Multifocal spikes [ojrd.biomedcentral.com]

These burst suppression patterns with associated interictal multifocal spikes and polyspikes in association with the specific neonatal clinical epileptiform activity must [frontiersin.org]

Normal BW: 3,180 g, HC: 36 cm PHB, B6, PHT 0-1 m: Suppression-burst. 1–7 m: Continuous EEG, multifocal spikes 7–24 m: Hypsarythmic pattern. >24 m: Frequent spikes and spike [ojrd.biomedcentral.com]