Figure 4.

Electroencephalography–functional magnetic resonance imaging of generalized paroxysmal fast activity (GPFA) and slow spike-and-wave (SSW) in individual LGS patients is shown. In individual patients, GPFA and SSW produce different blood–oxygen-level-dependent (BOLD) response patterns. GPFA shows increased BOLD in diffuse association network regions, as well as brainstem, basal ganglia, and thalamus. SSW shows a different pattern, with decreased BOLD signal in primary cortical areas. The number of events in seconds, at the bottom of each panel, is the sum of the length of all individual epileptiform events recorded during the EEG for each patient. Pt, patient. Re-printed with permission from Pillay and colleagues (72).