Interictal gamma oscillation regularity analysis and susceptibility-weighted imaging on focal epilepsy cases with alcohol use disorders.

Background: There has been no clear consensus on the clinical markers to distinguish alcohol-related seizures (ARSs) from epileptic seizures. We have reported the usefulness of gamma oscillation (30-70 Hz) regularity (GOR) analysis using interictal electroencephalography (EEG) data to evaluate epileptogenic focus. We conducted interictal GOR analysis using scalp EEG and susceptibility-weighted imaging (SWI) to visualize the epileptogenic focus in two cases initially suspected to have ARS.

Case description: In each case, a significantly high GOR area suggestive of epileptogenic focus was detected and that area was consistent with that where SWI showed hemosiderin deposit. In one patient, seizures were well controlled with the introduction of anti-seizure medication (ASM). In another patient, ASM was introduced but is refractory, and epilepsy surgery is being considered in the future.

Conclusion: The interictal GOR analysis and SWI can successfully contribute to identify the patients suspected to have ARS who may have epileptogenic focus and can be treated with ASM and epilepsy surgery.