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Flashcards in EPILEPTIFORM ABN Deck (54)
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1

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

Interictal epileptiform discharges (IED)

2

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

partial-onset seizures

3

WHAT IS THE PROBLEM?

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.

4

WHAT IS THE PROBLEM?

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.

5

WHAT ED ARE SEEN?

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.

6

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

spikes

 

sharp

7

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

Sharp waves

8

WHAT IS THE PROBLEM?

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

9

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

negative phase reversal

10

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

Anterior temporal spikes or sharp waves

11

WHAT IS SHOWN?

Bilateral anterior temporal sharp-and-slow wave in drowsiness

12

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

complex partial seizures

13

WHAT IS THE PROBLEM?

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

14

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

Mid-temporal IEDs

15

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

Benign childhood epilepsy with centrotemporal spikes (BCECTS;

16

WHAT IS THE PROBLEM?

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

17

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

negativity and positivity

18

WHAT IS THE PROBLEM?

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

19

WHAT KIND OF EPILEPSY?

 

A right frontal spike and polyspike discharge in frontal lobe

epilepsy

20

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

patients.

frontal lobe epilepsy (FLE)

21

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

Secondary bilateral synchrony (SBS)

22

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

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

23

WHAT CONDITION IS SHOWN?

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

24

WHAT IS THE PROBLEM?

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

25

WHAT IS SHOWN?

Midline spikes and polyspikes in a patient with frontal lobe

epilepsy.

26

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

Tonic seizures

27

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

Panayiotopoulos syndrome.

Occipital IEDs

28

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

who are ____________

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

29

WHAT IS SHOWN?

single right occipital spike-and-slow wave discharge shown

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

30

____________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

Multifocal spikes