• MYOCLONIC SEIZURES

- generalized spike-and-wave discharges followed

immediately by diffuse slow waves that correlate
SEIZURES AND EPILEPSY with the loss of muscle tone
• EPILEPTIC SPASMS
EEG PATTERNS
- generalized spike-and-wave discharges followed
• FOCAL ONSET SEIZURES:
immediately by diffuse slow waves that correlate
- Normal with the loss of muscle tone
- May show brief discharges termed EPILEPTIFORM - During clinical spasm: marked suppression of the
SPIKES or SHARP WAVES EEG background (the “electrodecremental response”)
- may be nonlocalizing (because focal seizures - EMG: characteristic rhomboid pattern that may help
may arise from the Medial temporal lobe or inferior distinguish spasms from brief tonic and myoclonic
frontal lobe) seizures.
• FOCAL SEIZURES WITH INTACT AWARENESS • LENNOX GASTAUT SYNDROME
- Abnormal discharges in a very limited region over - slow (<3 Hz) spike-and-wave discharges and a variety
the appropriate area of cerebral cortex if the seizure of other abnormalities
focus involves the cerebral convexity
• FOCAL SEIZURES WITH IMPAIRED AWARENESS
- Diagnosis is established with EEG
• TYPICAL ABSENCE SEIZURES (GENERAL)
- Electrophysiologic Hallmark:
+ burst of generalized, symmetric, 3-Hz,
spike-and-slow-wave discharges that begins
and ends suddenly
+ superimposed on a normal EEG background.
• ATYPICAL ABSENCE SEIZURES (GENERAL)
- Generalized, slow spike- and-slow-wave pattern
with a frequency of ≤2.5 per second
• GENERALIZED TONIC-CLONIC SEIZURES
-Tonic Phase EEG
+ progressive increase in generalized
low-voltage fast activity, followed by general-
ized high-amplitude, polyspike discharges.
- Clonic Phase EEG
+ high-amplitude activity is typically interrupted
by slow waves to create a spike-and-slow-wave
pattern.
+ Generalized seizures tend to terminate
synchronously over widespread brain regions.
- Postictal EEG
+ diffuse suppression of all cerebral activity,
then slowing that gradually recovers as the
patient awakens.