Pathological high frequency oscillations (HFOs, >80 Hz) are considered new biomarkers for epilepsy. They have mostly been recorded invasively, but pathological ripples (80-250 Hz) can also be found in scalp EEGs with frequent epileptiform spikes. Physiological HFOs also exist. They have been recorded invasively in hippocampus and neocortex. There are no reports of spontaneously occurring physiological HFOs recorded with scalp EEG. We aimed to study ripples in spike-free scalp EEGs. We included 23 children (6 with, 17 without epilepsy) who had an EEG without interictal epileptiform spikes recorded during sleep. We differentiated true ripples from spurious ripples such as filtering effects of sharp artifacts and high frequency components of muscle artifacts by viewing ripples simultaneously in bipolar and average montage and double-checking the unfiltered signal. We calculated mean frequency, duration and root mean square amplitude of the ripples, and studied their shape and distribution. We found ripples in EEGs of 20 out of 23 children (4 with, 16 without epilepsy). Ripples had a regular shape and occurred mostly on central and midline channels. Mean frequency was 102 Hz, mean duration 70 ms, mean root mean square amplitude 0.95 µV. Ripples occurring in normal EEGs of children without epilepsy were considered physiological; the similarity in appearance suggested that the ripples occurring in normal EEGs of children with epilepsy were also physiological. The finding that it is possible to study physiological neocortical ripples in scalp EEG paves the way for investigating their occurrence during brain development and their relation with cognitive functioning.
Keywords: Childhood; HFOs; High-frequency oscillations; Seizures; Surface EEG.