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Epileptiform bursts

Epileptiform bursts are a specific EEG pattern characterized by a series of rapid, repetitive spikes or sharp waves that indicate abnormal electrical activity in the brain, typically associated with seizure activity. 1.       Definition : o     Epileptiform bursts consist of brief, high-frequency discharges that can appear as spikes or sharp waves. These bursts are indicative of underlying epileptic activity and can occur in various seizure types. 2.      EEG Characteristics : o     The bursts are often more monomorphic and stereotyped compared to non-epileptic bursts, exhibiting greater rhythmicity, especially in the faster frequency ranges. This distinct waveform helps differentiate them from other types of EEG activity, such as those seen in non-epileptic conditions. o     Epileptiform bursts can vary in duration and frequency, and they may evolve into more complex patterns, such as generalized spike-and-wave discharges or other ictal patterns. 3.      Clinical Significa

Electrodecremental pattern

The electrodecremental pattern is a notable EEG finding associated with generalized-onset seizures and is characterized by a sudden and significant decrease in background amplitude. 1.       Definition : o     The electrodecremental pattern is defined by a sudden and generalized attenuation of the EEG signal, leading to a nearly isoelectric tracing across all channels. This pattern is often observed during seizures and can indicate significant cortical involvement. 2.      EEG Characteristics : o     The pattern typically begins with a high amplitude, generalized sharp wave, which is followed by a rapid and significant decrease in background amplitude (electrodecrement) that lasts approximately 1 second. After this initial decrement, fast (20 to 40 Hz) low-voltage rhythmic activity usually develops. o     The activity may gradually increase in amplitude and decrease in frequency over the subsequent few seconds, often evolving into generalized paroxysmal fast activity (GPFA).

Slow spike and (slow-) wave (complex)

  The slow spike and slow-wave complex (often abbreviated as SSSW complex) is an important EEG pattern associated with certain types of epilepsy, particularly those involving generalized seizures. 1.       Definition : o     The slow spike and slow-wave complex consists of a sequence of slow spikes followed by slow waves. This pattern is characterized by its relatively low frequency and is often seen in specific epilepsy syndromes. 2.      EEG Characteristics : o     The slow spikes typically have a frequency of less than 3 Hz, and the slow waves that follow are also of low frequency. The overall appearance is often irregular, and the complexes can be repetitive. o     This pattern may be maximal over frontal regions and can be associated with a variety of clinical manifestations, including seizures and interictal discharges. 3.      Clinical Significance : o     The presence of slow spike and slow-wave complexes is often indicative of underlying brain dysfunction and is

Generalized paroxysmal fast activity (GPFA)

  Generalized paroxysmal fast activity (GPFA) is an important EEG pattern associated with generalized seizures and certain types of epilepsy. 1.       Definition : o     GPFA is characterized by a sudden onset of fast-frequency activity, typically in the beta frequency range (15-25 Hz), that appears generalized across the EEG channels. This pattern is often seen during seizures and can indicate significant cortical involvement. 2.      EEG Characteristics : o     The GPFA pattern begins with low amplitude and fast frequency activity, which then evolves with an increasing amplitude and a decreasing frequency over a few seconds. This evolution can lead to a more complex pattern that may include spikes and slower waves. o     GPFA is distinct from other patterns like generalized spike and slow-wave complexes (GSW) due to its higher frequency and the nature of its evolution. It typically does not have the same triphasic appearance as GSW complexes. 3.      Clinical Significance

Generalized spike and slow-wave complex (GSW)

  The generalized spike and slow-wave complex (GSW) is a specific EEG pattern commonly associated with generalized seizures, particularly in certain epilepsy syndromes. 1.       Definition : o     The GSW complex consists of a sequence of spikes followed by slow waves, typically appearing as a triphasic waveform. This pattern is characterized by its repetitive nature and is often seen during both ictal (seizure) and interictal (between seizures) periods in patients with generalized epilepsy. 2.      EEG Characteristics : o     The GSW complex is usually maximal over the midline or frontal regions of the brain and can occur at a frequency that varies depending on the type of epilepsy. For example, in Lennox-Gastaut syndrome, the frequency may be less than 2.5 Hz, while in childhood absence epilepsy, it may be around 3 to 4 Hz. o     During an ictal event, the GSW complex occurs repeatedly without intervening background activity, and the duration of these complexes is typically

Epileptic recruiting rhythm

  The term "epileptic recruiting rhythm" refers to a specific pattern observed in the electroencephalogram (EEG) during certain types of seizures, particularly focal seizures. 1.       Definition : o     An epileptic recruiting rhythm is characterized by a progressive increase in amplitude and frequency of rhythmic activity observed in the EEG during a seizure. This pattern typically indicates the recruitment of additional cortical areas as the seizure evolves. 2.      EEG Characteristics : o     The recruiting rhythm often starts with a focal onset and may evolve into a more generalized pattern. The evolution of the rhythm is a key feature that helps in identifying the ictal activity. The rhythm can include repetitive sharp waves or spikes that become more pronounced as the seizure progresses. 3.      Clinical Significance : o     The presence of an epileptic recruiting rhythm can provide important information regarding the seizure's onset zone and its propag

Focal seizure with temporal lobe onset and generalization

Focal seizures with temporal lobe onset that generalize involve seizure activity that begins in the temporal lobe and subsequently spreads to involve both hemispheres of the brain. 1.       Ictal Patterns : o     The EEG during focal seizures with temporal lobe onset typically shows an initial focal pattern that may evolve into generalized rhythmic activity. This can include an increase in amplitude and the presence of high-frequency rhythms at the temporal electrodes, particularly on the side of the seizure onset. 2.      Clinical Manifestations : o     Patients may experience a range of symptoms, including alterations in consciousness, memory disturbances, and motor manifestations such as tonic posturing or clonic movements. The initial focal onset may present with specific symptoms related to the temporal lobe, such as auditory hallucinations or emotional changes, before progressing to generalized convulsions. 3.      EEG Characteristics : o     The ictal pattern often s

Focal seizure with broad neocortical onset

  Focal seizures with broad neocortical onset involve seizure activity that begins in a broad area of the neocortex, which is the outer layer of the brain responsible for higher-order functions such as sensory perception, cognition, and motor control. 1.       Ictal Patterns : o     The EEG during focal seizures with broad neocortical onset typically shows rhythmic slowing that evolves over time. This may include higher amplitude activity and phase-reversing spikes, indicating a more widespread involvement of the cortical areas. 2.      Clinical Manifestations : o     Patients may exhibit a variety of clinical symptoms depending on the specific areas of the neocortex involved. These can include motor manifestations (such as jerking movements), sensory symptoms, or alterations in consciousness. The clinical presentation can be diverse due to the extensive involvement of the neocortex. 3.      EEG Characteristics : o     The ictal pattern often starts with right-sided, fronta