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Ictal gamma (35\u201390\u00a0Hz) and beta (15\u201330\u00a0Hz) activities were correlated with visual symmetry of spasms, objective <jats:styled-content style=\"fixed-case\">EMG<\/jats:styled-content> (electromyography) analysis, and etiology of <jats:styled-content style=\"fixed-case\">WS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prior to the ictal motor manifestation, focal ictal gamma activity emerged from one hemisphere (71%, 24\/34) or from midline (26%, 9\/34), and was rarely simultaneously bilateral (3%, 1\/34). Focal ictal beta activity emerged from either one hemisphere (68%, 23\/34) or from midline (32%, 11\/34). Onsets of focal ictal gamma and beta activity were most commonly observed around the parietal areas. Focal ictal gamma activity propagated faster than ictal beta activity to adjacent electrodes (median: 65 vs. 170\u00a0msec, p\u00a0&lt;\u00a00.01), and to contralateral hemisphere (median: 100 vs. 170\u00a0msec, p\u00a0=\u00a00.01). Asymmetric peak amplitude of ictal gamma activity in the centroparietal areas (C3\u2010P3 vs. C4\u2010P4) correlated with asymmetric semiology. On the other hand, most of the visually symmetric spasms showed asymmetry in peak amplitude and interhemispheric onset latency difference in both ictal gamma and beta activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Spasms may be a seizure with focal electrographic onset regardless of visual symmetry. Asymmetric involvement of ictal gamma activity to the centroparietal areas may determine the motor manifestations in <jats:styled-content style=\"fixed-case\">WS<\/jats:styled-content>. Scalp <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> ictal gamma and beta activity may be useful to demonstrate localized seizure onset in infants with <jats:styled-content style=\"fixed-case\">WS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13735","type":"journal-article","created":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T12:25:24Z","timestamp":1491913524000},"page":"882-892","source":"Crossref","is-referenced-by-count":49,"title":["Scalp <scp>EEG<\/scp> Ictal gamma and beta activity during infantile spasms: Evidence of focality"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8318-2924","authenticated-orcid":false,"given":"Hiroki","family":"Nariai","sequence":"first","affiliation":[{"name":"Saul R. 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