{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:43:33Z","timestamp":1786653813866,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to observe the effects of various clinical factors on the activation and appearance of epileptiform abnormalities (EAs) in routine electroencephalography (rEEG) by different provocation methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This observational study involved a review of 136 patients presented for EEG recording due to various indications and their EEG showing EAs during various provocation methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Generalized spike-wave discharges (GSWDs) were the most frequent activated epileptiform pattern observed in, 81 (59.1%) recordings. This pattern was seen mainly in females 49 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00), in patients with generalized seizures 48 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00), in prolonged EEG records 3 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03), and in both genetic 35 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00) and lesional epilepsies 21 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00). Focal sharp waves with bilateral synchrony (FSWSBS) were the most activated ictal pattern (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00). Ictal EAs after hyperventilation (HV) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03) and intermittent photic stimulation (IPS) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01) were mainly observed in patients with uncontrolled seizures (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00), and immune-mediated epilepsy (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02). Females sex (odds ratio [OR]: 1.33, confidence interval [CI]: 0.6\u20132.6;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.25), bilateral tonic\u2013clonic seizures (OR: 1.17, CI: 0.5\u20132.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.31) and lesional epilepsies (OR: 1.45, CI: 0.7\u20132.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.20) had risk of activation of EAs by provocation methods; however this risk was not statistically significant. While sleep deprivation (SD) (OR: 6.33, CI: 2.2\u201318.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00), nonrapid eye movement sleep (NREM) (OR: 2.41, CI: 1.0\u20135.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00), and prolong EEG recording (OR: 1.91, CI: 0.9\u20133.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04) were leading to a statistically significant risk of activation and appearances of EAs due to provocation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Different provocation methods can activate and augment the variety of EEG patterns of diverse clinical significance. Detection of activated ictal EAs is dependent on various patient factors, including seizure control, and the provocation method applied. Further larger prospective cohort studies with adequate sample sizes are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_60_23","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:56Z","timestamp":1714608056000},"page":"160-168","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Factors Affecting the Activation and Appearances of Epileptiform Abnormalities in Routine Electroencephalography by Different Provocation Methods"],"prefix":"10.4103","volume":"23","author":[{"given":"Saima","family":"Nazish","sequence":"first","affiliation":[{"name":"Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,1]]},"reference":[{"key":"R1-20260505","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.clinph.2006.08.014","article-title":"Seizures and adverse events during routine scalp electroencephalography: A clinical and EEG analysis of 1000 records","volume":"118","author":"Angus-Leppan","year":"2007","journal-title":"Clin Neurophysiol"},{"key":"R2-20260505","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/WNP.0000000000000371","article-title":"Utility of EEG activation procedures in epilepsy: A population-based study","volume":"34","author":"Baldin","year":"2017","journal-title":"J Clin Neurophysiol"},{"key":"R3-20260505","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jocn.2017.08.014","article-title":"Clinical factors associated with the yield of routine outpatient scalp electroencephalograms: A retrospective analysis from a tertiary hospital","volume":"45","author":"Monif","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"Suppl 2","key":"R4-20260505","first-page":"i2","article-title":"EEG in the diagnosis, classification, and management of patients with epilepsy","volume":"76","author":"Smith","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R6-20260505","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1136\/jnnp.49.12.1386","article-title":"Relation of photosensitivity to epileptic syndromes","volume":"49","author":"Wolf","year":"1986","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R7-20260505","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/S1388-2457(99)00125-X","article-title":"Modern electroencephalography: Its role in epilepsy management","volume":"110","author":"Binnie","year":"1999","journal-title":"Clin Neurophysiol"},{"issue":"Suppl 1","key":"R8-20260505","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/j.1528-1167.2006.00654.x","article-title":"Interictal EEG and the diagnosis of epilepsy","volume":"47","author":"Pillai","year":"2006","journal-title":"Epilepsia"},{"key":"R9-20260505","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","article-title":"Definition of drug resistant epilepsy: Consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies","volume":"51","author":"Kwan","year":"2010","journal-title":"Epilepsia"},{"key":"R10-20260505","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.cnp.2017.07.002","article-title":"A revised glossary of terms most commonly used by clinical electroencephalographers and updated proposal for the report format of the EEG findings. 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