Changes in repeat electroencephalograms in epileptics

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Abstract
A series of patients with convulsive disorders who had repeated eeg examinations is presented. Changes in eeg patterns which occurred predominantly when convulsions were controlled or decreased in frequency are discussed. Patients with centrencephalic paroxysmal discharges may lose such discharges in subsequent eegs and show other patterns instead, such as small, sharp wandering spikes or even transient focal spike activity in one temporal lobe. It is postulated that the true centrencephalic discharges may be inhibited but that a cortical neuronal irritability, particularly in regions with a low epi-leptogenlc threshold, may persist when the disorder is relatively controlled or in an inactive phase. In patients with focal epileptogenlc discharges, independent mirror spike activity already may be present in an early stage of the disorder. Cases are presented in which an initially present, independent mirror focus is suppressed by anticon-vulsant treatment. Other cases demonstrate that a mirror focus ultimately may become the only active one while the initial focus is completely suppressed. This may have important consequences if temporal lobectomy is considered in selected cases. Total disappearance of previously present epileptogenic activity occurred in this series only in patients whose seizures were completely controlled. However, the occurrence of a grand mal attack may temporarily abolish the usually present epileptogenlc activity.

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