{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T01:06:09Z","timestamp":1785632769028,"version":"3.56.0"},"reference-count":9,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold><jats:italic>Objective<\/jats:italic><\/jats:bold>. We aimed to clarify the pathophysiology of epilepsy involving seizures with apparently generalized onset, progressing to focal ictal rhythm through stereotactic EEG (SEEG) implantation, recording, stimulation and highfrequency oscillation (HFO) analysis.<\/jats:p><jats:p><jats:bold><jats:italic>Methods<\/jats:italic><\/jats:bold>. We identified two patients with seizures with bilateral electrographic onset evolving to focal ictal rhythm, who underwent SEEG implantation. Patients had pre\u2010surgical epilepsy work\u2010up, including prolonged video scalp EEG, brain MRI, PET, ictal\/interictal SPECT, MEG, and EEG\u2010fMRI prior to SEEG implantation.<\/jats:p><jats:p><jats:bold><jats:italic>Results<\/jats:italic><\/jats:bold>. Both patients had childhood\u2010onset seizures involving behavioural arrest and left versive head and eye deviation, evolving to bilateral tonic\u2010clonic convulsions. Seizures were electrographically preceded by diffuse, bilateral 3\u2010Hz activity resembling absence seizures. Both had suspected focal lesions based on neuroimaging, including 3T MRI and voxel\u2010based post\u2010processing in one patient. Electrode stimulation did not elicit any habitual electroclinical seizures. HFO analysis showed bilateral focal regions with high fast\u2010ripple rates.<\/jats:p><jats:p><jats:bold><jats:italic>Significance<\/jats:italic><\/jats:bold>. \u201cGeneralized\u2010to\u2010focal\u201d seizures may occur due to a diffuse, bilateral epileptic network, however, both patients showed ictal evolution from a generalized pattern to a single dominant focus which may explain why the focal aspect of their seizures had a consistent clinical semiology. Patients such as these may have a unique form of generalized epilepsy, but focal\/multifocal cerebral abnormalities are also a possibility.<\/jats:p>","DOI":"10.1684\/epd.2022.1489","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T13:48:46Z","timestamp":1666360126000},"page":"1087-1094","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u201cGeneralized\u2010to\u2010focal\u201d epilepsy: stereotactic EEG and high\u2010frequency oscillation patterns"],"prefix":"10.1002","volume":"24","author":[{"given":"Nicolas","family":"von Ellenrieder","sequence":"first","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Dubeau","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy W.R.","family":"Dudley","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"},{"name":"Research Institute of the McGill University Medical Centre  Montreal Quebec Canada"},{"name":"Department of Neurology and Neurosurgery, Montreal Children's Hospital McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dufresne","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics Universit\u00e9 de Sherbrooke  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Gotman","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Baillet","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy T.","family":"Moreau","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Montreal Neurological Institute and Hospital McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Osterman","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Montreal Children's Hospital McGill University Health Centre  Montreal Quebec Canada"},{"name":"Division of Neurology, Department of Pediatrics Montreal Children's Hospital, McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Simard\u2010Tremblay","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Montreal Children's Hospital McGill University Health Centre  Montreal Quebec Canada"},{"name":"Division of Neurology, Department of Pediatrics Montreal Children's Hospital, McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Myers","sequence":"additional","affiliation":[{"name":"Research Institute of the McGill University Medical Centre  Montreal Quebec Canada"},{"name":"Department of Neurology and Neurosurgery, Montreal Children's Hospital McGill University Health Centre  Montreal Quebec Canada"},{"name":"Division of Neurology, Department of Pediatrics Montreal Children's Hospital, McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25304"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.00262.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001841"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000266386.55715.3f"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.10.025"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0387-7604(03)00030-5"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2011.0449"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02092.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2015.11.451"}],"container-title":["Epileptic Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1684\/epd.2022.1489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T07:35:09Z","timestamp":1713598509000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1684\/epd.2022.1489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":9,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1684\/epd.2022.1489"],"URL":"https:\/\/doi.org\/10.1684\/epd.2022.1489","archive":["Portico"],"relation":{},"ISSN":["1294-9361","1950-6945"],"issn-type":[{"value":"1294-9361","type":"print"},{"value":"1950-6945","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"2022-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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