OBJECTIVE: To identify neuronal networks underlying generalized spike and wave 
discharges (GSW) in myoclonic astatic epilepsy (MAE).
METHODS: Simultaneous EEG-fMRI recordings were performed in 13 children with 
MAE. Individual GSW-associated blood oxygenation level-dependent (BOLD) signal 
changes were analyzed in every patient. A group analysis was performed to 
determine common syndrome-specific hemodynamic changes across all patients.
RESULTS: GSW were recorded in 11 patients, all showing GSW-associated BOLD 
signal changes. Activation was detected in the thalamus (all patients), premotor 
cortex (6 patients), and putamen (6 patients). Deactivation was found in the 
default mode areas (7 patients). The group analysis confirmed activations in the 
thalamus, premotor cortex, putamen, and cerebellum and deactivations in the 
default mode network.
CONCLUSIONS: In addition to the thalamocortical network, which is commonly found 
in idiopathic generalized epilepsies, GSW in patients with MAE are characterized 
by BOLD signal changes in brain structures associated with motor function. The 
results are in line with animal studies demonstrating that somatosensory cortex, 
putamen, and cerebellum are involved in the generation of myoclonic seizures. 
The involvement of these structures might predispose to the typical seizure 
semiology of myoclonic jerks observed in MAE.