Epilepsy and 3 per second spike and wave rhythms [antikvár]

Chapter 1 INTRODUCTION In 1935 Gibbs, Davis and Lennox described the paroxysmal discharges in the electroencephalogram (EEG) of petit mal patients under the name of "the dart and dome pattern" or the spike and wave pattern. These discharges appeared as universally synchronous complexes consisting of a spike potential followed by a wave, the whole complex recurring about 3 times a second during the clinical seizure of petit mal. Similar discharges, although of only V2-2 seconds duration, were observed without concomitant clinical attacks. These discharges were limited to the frontal regions and were called larval paroxysms or abortive spike-wave patterns. The petit mal attack which was related to the spike-wave abnormality was defined by the authors as a transient loss of consciousness of 5-20 seconds duration without tonic spasms. If convulsive movements were present, they were limited to rhythmical clonic jerks of the eyelids, the head or the upper extremities and were of the same frequency as the spike-wave rhythm. This electro-clinical correlation revived the interest in Friedmann's disease (Friedmann 1906), which had been keenly discussed during the first quarter of the century. Now the problem of the nosological position and of the pathogenesis of petit mal could be analysed on the basis of the EEG and its clinical correlate, as well as the important problem of the frequent evolution of grand mal seizures in the course of petit mal epilepsy. As a result of investigations made during the following years, the spike-wave pattern partly lost its pathognomic significance for the diagnosis of petit mal. Spike-wave rhythms were found in the EEG's of patients with seizure types other than petit mal (Jasper and Kershman 1941, Finley and Dynes 1942, Echlin 1944, Silvermann 1954, Howell 1955, Haugsted and H0ncke 1956, Lundervold 1959). Outside the area of epilepsy the spike-wave abnormality has been described in rare cases and atypical forms in the EEG of patients with behaviour disorder (Jasper, Solomon and Bradley 1938, Gottlieb, Knott and Ashby 1945, Ando 1957, Rogina and Serafe-tinides 1962) and with psychosis (Hill 1948, 1956, Christian 1957, Gibson and Kennedy 1960) and with various forms of headache (Weil 1952, Froehlich, Carter, O'Leary and Rosenbaum 1960, Misés and Lerique 1960, Espadaler-Medina 1961).