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EEG > EPILEPTIFORM ABN > Flashcards

EPILEPTIFORM ABN Flashcards

1
Q

I______________ represent a distinctive group of waveforms that are characteristically seen in personS with epilepsy

A

Interictal epileptiform discharges (IED)

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2
Q

Abnormal focal interictal epileptiform discharges on EEG represent a heightened predisposition for the expression of__________

A

partial-onset seizures

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3
Q

WHAT IS THE PROBLEM?

A

Intracranial versus scalp recording (in the bottom six channels) during a presurgical evaluation of intractable epilepsy. Sensitivities in the top channels are 75 μv versus 7 μv/mm at the scalp. Note the absence of IEDs in the scalp EEG compared to the intracranial EEG where they occur at 1/sec.

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4
Q

WHAT IS THE PROBLEM?

A

Intracranial versus scalp recording (in the bottom six channels) during a presurgical evaluation of intractable epilepsy. Sensitivities in the top channels are 75 μv versus 7 μv/mm at the scalp. Note the absence of IEDs in the scalp EEG compared to the intracranial EEG where they occur at 1/sec.

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5
Q

WHAT ED ARE SEEN?

A

Different morphologies include sharp waves (seen during seconds 1 and 2), spikes and sharp waves (in second 3), polyspike-and-slow waves (in second 4), and spike-and-wave discharges (in the last second of the figure) recorded during an ambulatory EEG in a patient with epilepsy.

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6
Q

Both ______and _______waves are referred to as interictal epileptiform discharges (transients)

A

spikes

sharp

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7
Q

________are more “blunted” than spikes and are IEDs with a duration of 70 to 200 msec.

A

Sharp waves

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8
Q

WHAT IS THE PROBLEM?

A

EEG demonstrating a couplet of left anterior temporal spike and- slow waves.

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9
Q

Interictal epileptiform discharges (spikes and sharp waves) are almost always surface negative, generating the typical_________

A

negative phase reversal

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10
Q

___________often have a clinical association with complex partial seizures of temporal lobe origin more than 90% of the time

A

Anterior temporal spikes or sharp waves

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11
Q

WHAT IS SHOWN?

A

Bilateral anterior temporal sharp-and-slow wave in drowsiness

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12
Q

Anterior temporal spikes or sharp waves often have a clinical association with ___________of temporal lobe origin more than 90% of the time

A

complex partial seizures

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13
Q

WHAT IS THE PROBLEM?

A

Left mid-temporal sharp wave in a patient with temporal lobe epilepsy. Note the focal theta and delta slowing regionally in the same region.

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14
Q

________also occur in patients with temporal lobe epilepsy (TLE). In general, they are often more regional in distribution with neocortical TLE

A

Mid-temporal IEDs

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15
Q

____________also called rolandic epilepsy) is a common childhood idiopathic localization-related epilepsy syndrome

A

Benign childhood epilepsy with centrotemporal spikes (BCECTS;

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16
Q

WHAT IS THE PROBLEM?

A

Left centroemporal spikes in a patient with BCECTS. Notice the central field of spread of the spikes and low-amplitude right frontal positivity.

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17
Q

The characteristic tangential or horizontal dipole that is formed in BCECTs demonstrates both a _____________during the discharge. This has been used to separate the more “benign” nature of BCECTs from a more pathological rolandic sharp wave

A

negativity and positivity

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18
Q

WHAT IS THE PROBLEM?

A

The same spikes depicted in Figure 3.7 demonstrated on linked ears reference montage. Note the frontal positivity denoting the tangential dipole of BCECTs

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19
Q

WHAT KIND OF EPILEPSY?

A

A right frontal spike and polyspike discharge in frontal lobe

epilepsy

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20
Q

Frontal spikes are often found in patients with ______________, although they may be absent in up to one-third of

patients.

A

frontal lobe epilepsy (FLE)

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21
Q

__________or diffuse discharges arising from a focal point in the frontal lobe may occur in up to twothirds of individuals with FLE

A

Secondary bilateral synchrony (SBS)

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22
Q

Some conditions may give rise to central spikes without epilepsy and include ________, _________, _________and normal variants (i.e., fragmented mu rhythm)

A

cerebral palsy, migraine, and inherited trait without seizures (i.e., siblings of those with BCECTS),

23
Q

WHAT CONDITION IS SHOWN?

A

Right central spike-and-slow wave IEDs and focal slowing in a patient with a right frontal tumor and partial seizures.

24
Q

WHAT IS THE PROBLEM?

A

Right central spike-and-slow wave IEDs and focal slowing in a patient with a right frontal tumor and partial seizures.

25
Q

WHAT IS SHOWN?

A

Midline spikes and polyspikes in a patient with frontal lobe

epilepsy.

26
Q

No distinct clinical syndrome exists for patients with midline spikes. ________ are the most frequent seizure type

A

Tonic seizures

27
Q

________are most frequently reported in the benign childhood epilepsies with occipital paroxysms and the later-onset

Panayiotopoulos syndrome.

A

Occipital IEDs

28
Q

Occipital spikes may appear in nonepileptic patients who express the IEDs as a genetic trait, or those

who are ____________

A

Congenitally blind (“needle spikes” of the blind).

29
Q

WHAT IS SHOWN?

A

single right occipital spike-and-slow wave discharge shown

in both a bipolar and reference montage (last two channels).

30
Q

____________may be seen in individuals with discrete structural lesions, although usually they are associated with diffuse structural injury involving the gray matter of the hemispheres

A

Multifocal spikes

31
Q

_________ AND _________are common underlying substrates for patients with multifocal independent spike discharges

There may be a primary site of focal dysfunction or be associated with concomitant generalized epileptiform discharges such as with the________

A

Mental retardation and cerebral palsy

Lennox-GastauT syndrome.

32
Q

WHAT IS SHOWN?

A

Multifocal independent spike discharges seen in a patient

with encephalopathic generalized epilepsy

33
Q

_____________is a term used for a generalized discharge with a focal onset

A

Secondary bilateral synchrony (SBS)

34
Q

Patients with medial frontal seizures such as those with supplementary motor area, medial frontal convexity, or cingulate gyrus area involvement are most likely to manifest SBS given their proximity to the____________

A

corpus callosum

35
Q

WHAT IS SHOWN?

A

A burst of secondary bilateral synchronous burst of sharpand- slow waves. Note the left frontotemporal spikes prior to the burst.

36
Q

______________consists of a burst of generalized spikes and/or polyspike-and-slow wave complexes provoked by photic stimulation

A

A photoparoxysmal (PPR) or photoconvulsive response

37
Q

PPR has a clinical correlation with _____________although it may also appear as an inherited trait without seizures

A

idiopathic generalized epilepsy (IGE),

38
Q

THIS PATIENT WAS EVALUATED FOR HEADACHES

A

Self-limited photoparoxysmal response in a patient without

seizures evaluated for headaches.

39
Q

The prototypic abnormality on EEG seen with generalized seizures is the____________

A

3-Hz spike-and-slow-wave complex.

40
Q

Alerting responses inhibit generalized spike-and-wave (GSW), while ______________often increase it in IGE.

A

sleep, hyperventilation, and intermittent photic stimulation

41
Q

WHAT IS SHOWN

A

A generalized burst of 3-Hz spike-and-slow waves in a

patient with IGE and absence seizures

42
Q

Spike-and-slow-wave complexes that have a repetition rate of >3 Hz are referred to as fast GSW. ___________is the most common idiopathic generalized epilepsy (IGE) syndrome associated with iy

A

JME

43
Q

WHAT SYNDROME IS ASSOCIATED?

A

A burst of generalized 3.5-Hz spike-and-slow waves in JME

44
Q

The most characteristic feature on EEG in patients with __________predominant “fast” polyspike-and-slow wave (PSW) complexes, although this may also be seen in other IGEs as well

A

JME

45
Q

________is a potent activator of the generalized IEDs seen with JME. ________may occur in up to 40% of patients with JME and is more prominent in females.

A

Sleep deprivation

Photosensitivity

46
Q

WHAT SYNDROME IS ASSOCIATED?

A

Generalized polyspike-and-slow wave in a patient with JME

47
Q

_______is a distinctive pattern that is seen in children and often associated with infantile spasms as a manifestation of West syndrome

A

Hypsarrhythmia

48
Q

Many patients with hypsarrhythmia evolve into the

pattern of diffuse slowing, multifocal IEDs, and slow-spike-and-waves

characteristic of the_______

A

Lennox-Gastaut syndrome

49
Q

WHAT SYNDROME IS ASSOCIATED?

A

Hypsarrhythmia in a child with infantile spasms that is

“modified” due to a right congenital brain malformation. Note the high-amplitude,

chaotic background and multifocal spikes within the left hemisphere

50
Q

Slow-spike(or sharp)-and-wave discharges (SSW) are <3 Hz and are present in patients with the________

A

Lennox-Gastaut syndrome (LGS).

51
Q

CHARACTERISTICS OF WAVE PATTERNS OF LGS

A

They often appear as repetitive bursts or runs of frequencies ranging from 1.5 to 2.5 Hz and often asymmetrical or shifting and prolonged in sleep

52
Q

WHAT SYNDROME IS ASSOCIATED?

A

Slow-spike-and-wave in a patient with Lennox-Gastaut

syndrome.

53
Q

WHAT IS SHOWN?

A

An asymptomatic burst of GPFA in a patient with the

Lennox-Gastaut syndrome and tonic seizures

54
Q

____________is another feature on

EEG that occurs with the slow spike-and-waves of LGS. It is primarily

seen during sleep and consists of diffuse, bilateral bursts of 15

to 20 Hz frontally predominant bursts of fast frequencies

A

Generalized paroxysmal fast activity (GPFA)

EEG (7 decks)

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