Temporo-Spacial Correlations between Cortical and Subcortical EEG Spike-Wave Complexes of the Idiopathic Lennox-Gastaut Syndrome

All-night EEG recordings of the interictal 2/s spike-wave complexes (SKW) from different cortical and subcortical regions were performed in 5 patients with atypical absences of the Idiopathic Lennox-Gastaut syndrome (ILGS), in whom multicontact depth electrodes were implanted in the centromedian thalamic region as a part of a neuroaugmentive procedure for seizure control. Since during slow wave sleep III cortical spike (S2) and subcortical negative spike (NSK) consisting of simple monophasic negative potentials appeared together with a ratio of almost 1:1 and with fixed temporal relations, it was possible to determine visually the differences in peak-to-peak intervals of S2 and NSK, as well as their amplitude distribution in different cortical and subcortical structures. It was found that the peak of subcortical NSK preceded by 35 ms that of cortical S2. In addition, subcortical NSK and cortical S2 potentials attained maximal amplitude at the mesencephalic-thalamic reticular and frontal cortical regions, respectively, from which amplitude of NSK and S2 decreased with distance to other subcortical and cortical regions. These data suggest that interictal 2/s SKW of the ILGS result from ascending reticular impulses impinging upon the frontal cortical neurons.