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Abstract

This study deals with 2,200 electroencephalograms recorded in a mental hospital. We have found that 576 of these EEG's gave an epileptiform activity (26%) whereas 1,624 (74%) did not show any epileptiform activity.

Among the 576 epileptiform activity cases, 296 were of a localized form in one of the cortical areas and 280 were of a non localized form.

Among the localized forms the most important were the temporal localizations which could be equally divided in left or right temporal regions. Among the non localized forms, the outstanding ones were of the centrencephalic origin including the idiopathic type or the non idiopathic type.

The usual technique in the recordings comprises monopolar and bipolar explorations during rest and followed by reactivation by hyperventilation or photic stimulation and in some cases by gradual intravenous injection of metrazol. The explorations by the naso-pharyngeal electrode are routinely made in each case.

It is to be emphasized that on this total of 2,200 cases, 827 had been referred to us as clinical cases of epilepsy. These were confirmed only in 69.5% meaning that the EEG was of no value in 30.5%. These figures would compare rather sharply with those of Gibbs, Gibbs & Lennox in a study made in 1943, where they confirmed a clinical diagnosis of epilepsy in 58%. These authors concluded that the EEG was of no value in 42% of clinical epilepsy whereas we found that 30.5% were not confirmed in our study.

Among these cases that were not confirmed by the EEG, we suspect that we could still break down this figure by the cortical recording as we have seen in some recent publications that many of those silent scalp recordings could give paroxysmal epileptiform activity through a cortical or a depth recording. We have seen many examples of these subcortical paroxysmal discharges during a quiet recording of the surface.

We have also found that in some routine examinations among non-epileptic psychotics, we had about 10% of those cases that would show epileptiform activity. This would not necessarily mean that this 10% will absolutely give epileptiform seizures in the future but we might keep in mind that, even in a normal population, these cases might be susceptible of giving such abnormal seizures according to multiple exterior factors.

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