GENERALIZED SZ

Question 1

____________ associated with symptomatic generalized epilepsy are more heterogeneous but are characteristic of patients with diffuse structural injury.

Answer 1

Generalized seizures

Question 2

WHAT IS SHOWN?

Answer 2

A brief 1-sec burst of 3-Hz generalized polyspike-spike-andwave

that is associated with a “postictal” arousal

Question 3

When bursts of 3-Hz spike-and-waves are generalized, regular, symmetrical, synchronous, and maximal in the anterior head regions and are longer than 3 sec, the EEG strongly suggests the diagnosis of___________

With aging, absence seizures may become more_______

Answer 3

absence seizure (petit mal).

irregular and slower in frequency

Question 4

WHAT IS SHOWN?

Answer 4

Absence seizure. Note the asymmetrical left frontal onset

Question 5

When prolonged bursts of generalized spike-and-waves (GSW) last >3 sec, __________ is likely to become clinically evident. Shifting asymmetries are not unusual and do not constitute a focal onset.

Answer 5

Impaired responsiveness

Question 6

WHAT SEIZURE IS EXHIBITED?

Answer 6

Absence (petit mal) seizure in an 8-year-old boy.

Question 7

WHAT IS SHOWN?

Answer 7

Atypical absence seizure in a patient with encephalopathic generalized epilepsy. Notice the polyspikes that evolve to a slow spike-andwave

pattern.

Question 8

________are associated with a single complex or burst

of generalized spike or polyspike-and-waves

Answer 8

Myoclonic seizures

Question 9

WHAT IS SHOWN?

Answer 9

Myoclonic seizure associated with a burst of generalized polyspike- and-waves in a patient with juvenile myoclonic epilepsy (JME)

Question 10

WHAT TYPE OF SZ?

Answer 10

Myoclonus followed by generalized tonic-clonic seizure in a

patient with JME.

Question 11

Generalized tonic-clonic (GTC), or “grand mal” seizures, are generalized seizures with a tonic and clonic component. The EEG demonstrates a ______that is composed of repetitive alpha frequencies in the maximal anterior head regions

Answer 11

“recruiting rhythm”

Question 12

_____are brief tonic spasms that involve head flexion and

arm abduction and extension for seconds, usually occurring in clusters between 1 and 3 years of age

Answer 12

Infantile spasms

Question 13

EEG OF INFANTILE SPASM

Answer 13

The spasms begin with an abrupt generalized electrodecremental response on EEG with generalized attenuation of the background frequencies which may have faster frequencies superimposed lasting from <1 sec to several seconds.

Question 14

WHAT IS SHOWN?

Answer 14

Infantile spasm noted in second 7 above with an electrodecremental response obtained in a 3-year-old child with tuberous sclerosis. Note the high amplitude. Infantile spasms are brief tonic spasms that involve head flexion

Question 15

_______typically have an abrupt onset of a generalized 10-Hz rhythm on EEG. Generalized paroxysmal fast activity is often seen as the associated features on EEG, although it may have no apparent clinical features associated with brief bursts that occur during sleep

Answer 15

Tonic seizures

Question 16

WHAT IS SHOWN?

Answer 16

Tonic seizure in a patient with Lennox-Gastaut syndrome

Question 17

O que caracteriza o padrão de hipsarritmia?

Answer 17

surtos de espículas e complexos onda aguda-onda lenta
generalizados, seguidos de depressão difusa do traçado

Question 18

criança de 7 meses, sonolenta. O que vc vê?

Answer 18

Padrão de hipsarritmia + fusos do sono mostrados pela seta

Question 19

Paciente com 9 anos. Sono. O que voce ve?

Answer 19

Paroxismos de poliespicula generalizada, Lennox Gastaut

Question 20

Paciente com 15 anos, sonolencia. Qual o diagnostico?

Answer 20

epilepsia mioclonica juvenil

Question 21

Paciente, 7 anos, vigilia. Quais os achados?

Answer 21

complexos regulares de espícula-onda lenta generalizados, na frequencia de 3HZ

Question 22

Qual é ausencia tipica?
Qual é atípica?

Answer 22

Típica A

Atípica B