Detailed examination of the precipitating events revealed action-programming type activities to be the most crucial in 32 out of the 38 patients (84.2%), followed by thinking type activities in four patients (10.5%). writing (68.4%), written calculation (55.3%) and spatial conction (63.2%), provoked the most discharges, followed by mental calculation (7.9%) and reading (5.3%). Among the cognitive tasks, mental activities mainly associated with use of the hands, i.e. The NPA tasks provoked epileptic discharges in 38 patients (7.9%) and were accompanied by myoclonic seizures in 15 patients, absence seizures in eight and simple partial seizures in one.
NPA tasks consisted of reading, speaking, writing, written arithmetic calculation, mental arithmetic calculation and spatial construction. To examine the effects of higher mental activity on the EEG, 480 Japanese patients with different types of epilepsy were subjected to potentially provocative cognitive tasking, termed `neuropsychological EEG activation' (NPA), during standard EEG recordings.
