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In 16 children with eligible EEG data (7 with epileptic spasms and 9 with other seizure types) and 16 controls, 2 spike metrics were calculated through automated detection followed by expert review: (1) spike rate (spikes per minute) and (2) number of unique spike foci. In patients who developed seizures, a combination of spike rate threshold of \u22652 per minute and \u22652 unique spike foci during sleep was highly predictive of impending epileptic spasms (100% positive predictive value, 2 false negatives). One control patient was falsely predicted to develop epileptic spasms, decreasing the overall positive predictive value to 83.3%. These findings suggest that EEG spike metrics could predict impending epileptic spasms in children with tuberous sclerosis complex, pending larger-scale validation.<\/jats:p>","DOI":"10.1177\/08830738251347523","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:19:34Z","timestamp":1751948374000},"page":"60-67","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Electroencephalogram (EEG) Spike Metrics Discriminate Impending Epileptic Spasms From Other Seizures in Children With Tuberous Sclerosis Complex: A Pilot Study"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0237-1598","authenticated-orcid":false,"given":"Pauline J.","family":"Brandon Bravo Bruinsma","sequence":"first","affiliation":[{"name":"Harvard Medical School"},{"name":"Boston Children's Hospital"},{"name":"Faculty of Medicine, Vrije Universiteit Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9926-2080","authenticated-orcid":false,"given":"Aristides","family":"Hadjinicolaou","sequence":"additional","affiliation":[{"name":"Harvard Medical School"},{"name":"Boston Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9685-7118","authenticated-orcid":false,"given":"Rajsekar R.","family":"Rajaraman","sequence":"additional","affiliation":[{"name":"UCLA Mattel Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun A.","family":"Hussain","sequence":"additional","affiliation":[{"name":"UCLA Mattel Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7250-7391","authenticated-orcid":false,"given":"Darcy A.","family":"Krueger","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-2953","authenticated-orcid":false,"given":"Mustafa","family":"Sahin","sequence":"additional","affiliation":[{"name":"Harvard Medical School"},{"name":"Boston Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hope","family":"Northrup","sequence":"additional","affiliation":[{"name":"McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth) and Children's Memorial Hermann Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6346-7327","authenticated-orcid":false,"given":"Brenda E.","family":"Porter","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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