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Flashcards in FOCAL SZ Deck (20)
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1

AT WHAT STAGE OF SLEEP?

The above EEG shows a simple partial seizure that occurred out of stage 2 sleep.

2

WHAT EPILEPSY SYNDROME?

 

Interictal EEG manifestations include anterior temporal spikes at 0.5 to 1.5 Hz or rhythmic 2 to 4 Hz facilitated

by drowsiness and light non-REM sleep

MTS

3

ICTAL EEG PATTERN OF MTS

A frequent ictal pattern of mesial temporal origin is the sudden appearance of localized or regional background attenuation, build-up of 4- to 7-Hz rhythmic activity, increasing in amplitude as it slows to 1 to 2 Hz. This may befollowed by suppression or slow activity.

4

WHAT SZ TYPE?

Right temporal 6- to 7-Hz rhythmic ictal theta discharge at

seizure onset in a patient with temporal lobe epilepsy

5

Although it may be difficult to clinically distinguish ________________from mesial temporal lobe seizures, they may have a widespread hemispheric onset, begin in the mid-temporal derivations at <5 Hz, have rapid propagation to extratemporal structures, and have a greater likelihood to secondarily generalize

neocortical temporal lobe seizures 

6

WHAT IS SHOWN?

Left temporal neocortical seizure onset with rhythmic 3-Hz

delta maximal in the mid-temporal derivation prior to rapid generalization

7

LOCALIZATION OF SZ

Right “focal” temporal seizure confined to the right subtemporal (RST) 1 to 3 electrodes on intracranial recording. L(R)ST = left (right) subtemporal; L(R)LT = left (right) lateral temporal; L(R)OF = left (right) orbitofrontal.

8

9

LOCALIZATION OF SZ

Discrete focal seizure onset in a patient with a right frontal

lesion.

10

___________often has very brief, bizarre, bimanualbipedal automatisms with nocturnal predominance and be prone to acute repetitive seizures and status epilepticus

Frontal lobe epilepsy

11

WHAT IS SHOWN?

Nonlocalized ictal EEG in frontal lobe epilepsy. Notice the

brief right frontal-central repetitive spikes in seconds 7 to 8

12

_________are seizures that begin in the mesial frontal lobe and therefore often may have brief and bizarre semiologies that mimic psychogenic nonepileptic seizures (pseudo-pseudoseizures).

The clinical semiology may also manifest a “fencer’s” posture that provides more localizing value than surface ictal EEG (see above) with the side of tonic extension reflecting the side opposite seizure onset

Supplementary motor seizures

13

WHAT SZ TYPE IS SHOWN?

Diffuse electrodecremental response in a patient with a supplementary motor seizure.

14

_________seizures are often clinically silent. Somatosensory involvement may yield a perception of tingling, formication, pain, heat, movement, or dysmorphopsia, typically of the distal limb or

face

Parietal lobe

15

LOCALIZATION OF SZ?

 

The tracing shows high-frequency, mu-like arcuate waveforms focally over the left parietal C3-P3 derivations at 10 Hz in the region of a brain tumor.

16

High-frequency discharges at the _______junction can induce contraversive nystagmus and eye and head deviation

temporoparieto-occipital

17

SZ LOCALIZATION?

Right occipital lobe seizure with a build-up of right occipital

6- to 7-Hz rhythmic ictal theta associated with the patient’s complaint of left visual field loss.

18

Seizures may occur without awareness or be very subtle such that clinical signs are not noted. These are especially common in patients with complex partial seizures. When testing is performed, some seizures exhibit no evidence of interruption in behavior. Such is the case with brief absence seizures.

 

WHAT SZ TYPE?

Subclinical seizures

19

DESCRIBE THIS SEEN IN A PT WITH NO ELECTROGRAPHIC SZ

Subclinical seizure in a patient with encephalopathic generalized epilepsy. There were no clinical signs noted during multiple brief seizures

20