14 Eeg

Front 1

Types of abnormities

Back 1

1. Focal polymorphic slow activity - delta/theta, if continuous - cerebral lesion
2. Generalized polymorphic slow activity - encephalopaties
3. Intermittent monomorphic slow activity - Paroxysmal bursts of generalized bisynchronous rhythmictheta delta - thalamocortical dysfunction, metab/toxic, obstr hydocephalus, deep posterior fossa lesions or nonspecific in generalized epilepsy;
   focal bursts of rhythmic waves in one hemisphere - usually thalamic or periventricular activities
4. Voltage atenuation - generalized (anoxia, degnerataions, brain death); focal (atrophy,extraaxial lesion)
5. epileptiform - spikes (hrot <80ms), sharp waves (80-200 ms), spike-wave complexes, PSW (polySW)
   

Front 2

Epilepsy

Back 2

90% of epilepsy patients with epileptiform discharges, but poor corelation with frequency of seizures

excesife focal or gen. slow-wave activity

Front 3

Seizures

Back 3

GTCS - bilaterally synchronous diffuse bursts of spikes and spike-and-wave discharges

Simple motor or sensory sizures - anterior temporal spikes

Primitive visual hallucination - occipital spikes

Front 4

Syndromes epi

Back 4

1. hypsarrhythmia - infantile spasms (West syndrome)
   
2. 3-Hz spike-andwave activity - typical absence attacks (childhood or juvenile absence epilepsy)
3. generalizedpolyspike-wave pattern - myoclonic epilepsy, incl. juvenile myoclonic epilepsy
   
4. generalized slow spike-and-wave pattern - Lennox–Gastaut syndrome
   
5. central-midtemporal spikes - benign rolandic epilepsy

Front 5

Other

Back 5

Focal - arrhythmic or polymorphic activity

Metabolic

• slow-wave, high voltage, triphasic morhpology - hepatic or uremia, hyponatr, hyperthyreosis
• generalized rhythmic beta - drug intoxication
• generalized volt. suppression - hypothry, anoxia
• photoconvulsive response - uremia
• focal seizure activity - hyperosmolar coma

Hypoxia

alpha coma, burst suppression pattern (with myoclon), periodic pattern ( spikes 1-2 per second, with myoclon

HSV - diffuse slow wave activity, mainly temporal

CJD - generalized periodic sharp-wave complexes in dementia

Front 6

Nonconvulsive

Back 6

Repetitive generalized or focal spikes, sharp waves, spike and-wave, or sharp-and-slow wave complexes at ≥3/sec.

Front 7

Periodic discharges

Back 7

spikes, sharp waves or sharply contoured slow waves every 1-2 s

generalized (GPD), lateralized (LPD; PLED); bilaterally independent (BIPD; BIPLED)

focal brain injury, poor outcome after status epilepticus