Pseudo-epileptiform patterns Flashcards
Six hertz spike-and-slow-wave (‘wave and spike phantom’) – wave shape, duration, distribution, age, vigilance
- miniature (<5Hz more likely epileptic)
- adult
- drowsy - usually goes away during deeper levels of sleep
Fourteen and six hertz positive bursts (‘ctenoids’)– wave shape, duration, distribution, age, vigilance, other associated conditions
- repetetive positive spikes arch-shaped - best seen in referential montage
- less than 1-2 sec
- post -TEMPORAL, parietal, bilaterally independent or synchronous
- adolecents, children
- sleep/drowsy
- also seen in comatose, Reye’s, toxic liver disease, metabolic, or anoxic events
Rythmic temporal theta burst of drowsiness
(Rythmical mid-temporal discharge ‘RMTD’ , ‘Psychomotor variant’) – wave shape, duration, distribution, age, vigilance
- rythmic THETA 4-7Hz negative sharp waves with notched or flat phases, usually monomorphic or monorhythmic with no evolution(different than seizure)
- few seconds
- midTEMPORAL, unilateral, bilateral, idependent, or synchronous
- middle aged females
- sleep/drowsy
Small sharp spikes (‘sss’), ‘benign epileptiform transients of sleep (‘BETS’) – wave shape, duration, distribution, age, vigilance
- short spikes, small, mono or biphasic - horizontal dipole –> true phase reversal
- less than 65msec for single phrase - rarely repeat with same configuration/morphology
- mid-and anterior temporal shifting distribution
- adults/adolescents
- drowsy/sleep
Wiket spikes – wave shape, duration, distribution, age, vigilance
- repetetive spikes forming arches
- repeats every few seconds
- anterior and mid temporal
- adults
- awake/asleep
Occipital spikes and sharp waves of blind persons – wave shape, duration, distribution, age, vigilance
- focal spike and sharp waves
- 200ms
- occipital, uni or bilateral
- children
- awake/asleep
Subclinical Rythmical Electrographic (Theta) Discharge in Adults (‘SREDA’) – wave shape, duration, distribution, age, vigilance
UNCOMMON
- mono or bi-phasic sharp followed by rythmic THETA 4-7Hz waves
- 20 sec to more than 5 min- repeats many times
- assymmetric/symmetrical posterior temporal and parietal
- ADULTS >50 years old
- awake/asleep - hyperventilation
Paroxysmal hyponogogic hypersynchrony – wave shape, duration, distribution, age, vigilance
- 3-5hz moderate to high amplitude intermixed spikes
- 1-6 seconds
- generarlized, maximum anterior to posterior
- children
- drowsy
Midline theta rythyms (of Ciganek) – wave shape, duration, distribution, age, vigilance
- THETA 4-7Hz rythmic trains with sinusoidal, spiky, archiform sharp
- 4-20 seconds (variable)
- MIDLINE, central
- chilren > adults
- awake/drowy - variable reactivity