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Normal EEG

iF YOU FIND ANY ABNORMALITY


TRY TO DETECT IF THIS ABNORMALITY IS GENERALIZED PRESENT IN ALL TRACE OR LOCALIZED (LIMITED
TO PARTICULAR TRACE)
LESIONS WHICH OCCUR IN ALL LEADS
*ABSENCE EPILEPSY
*HYPERAARTHYMIA
*SUB ACUTE SCLEROSING PAN ENCEPHALITIS
*GRAND MAL EPILEPSY
*MYOCLONIC EPILEPSY
LESION WHICH MAY BE LOCALIZED ARE:
HERPES ENCEPHALITIS OCCUR MAINLY IN TEMPORAL LOBES
TEMPORAL LOB EPILEPSY (ANT TEMPORAL REGION)
BENIGN ROLANDIC EPILEPSY (CENTRO TEMPORAL REGION)
OVER SPACE OCCUPYING LESION

DETECT THE NATURE OF THE WAVE


IF IT IS SPIKE WAVE OR SLOW WAVE

CLASSIFY THE LESION ACCORDING TO WAVES SEEN IN EVERY ONE


SPIKE WAVES ARE PRESENT IN
1-ABSENCE EPILEPSY
2-GRAND MAL EPILEPSY
3-MYOCLONIC EPILESY
4-CENTROTEMPORAL SPIKE
5-TEMPORAL LOBE EPILEPSY
SLOW WAVES ARE PRESENT IN
1-SUBACUTE SCLEOSING PANENCEPHALITIS
2-HERPES ENCEPHALITIS
3-ACUTE ENCEPHALOPATHY
MIXED SPIKE AND SLOW WAVES:
1-HYPERARRTHYMIA
2-LENNOX GASTAUT

EEG waveforms are generally classified according to their


1-frequency,
2-amplitude
3-shape
4-the sites on the scalp at which they are recorded.
The most familiar classification uses EEG waveform frequency ( alpha, beta, theta, and delta)

A 2 month old infant presents with tonic spasms and myoclonic seizures.
Describe EEG?
Which of the following pediatric epilepsy syndromes does this patient have?

A) Ohtahara syndrome
B)Benign rolandic epilepsy

C) Childhood absence epilepsy

D) Lennox-Gastaut syndrome

E) Landau-Kleffner syndrome

Burst suppression
Otahara syndrome

Benignrolandic
Contraindicated carbamazepine

A 3 year-old boy presents to your clinic for evaluation. He is developmentally delayed, and has had
seizures for the past 2 years. Seizure types include generalized tonic-clinic, atonic, tonic, and
absence.
Describe EEG?
Of the following treatments, which is most likely to have a beneficial effect in the treatment of this
boy's seizures?
A) Tiagabine

B) Oxcarbazepine

C) Primidone

D) Gabapentin

E) Topiramate

Lennox Gastaut syndrome...toprimate

EEG of an 11-year-old patient with learning difficulties describe A & B


DX?

SSPE AND THE SECOND DURING A SEIZURE

A previously bright 9 years old girl from a migrant family presented to outpatient clinic with Hx of
academic deterioration. Mum reports frequent dropping of cutlery. She was noted to have intermittent
jerking of arms and legs
EEG and EMG attached

SSPE

Decreased concentration and deterioration if school work

Absence seizure

A 9 year-old girl presents to your office accompanied by her parents. The parents state that on 4
occasions over the past several months, the girl has come into their room in the early morning,
drooling and having difficulty talking, with a slight facial droop. These symptoms resolved fairly
quickly on both occasions. Then, this morning, she had a generalized motor seizure. There is no
significant past medical history, and no family history of epilepsy. The patient had a normal birth
history, and has consistently met her developmental milestones. Physical exam is normal. An EEG is
obtained, and is shown.
what is the most likely diagnosis and prognosis?

Benign rolandic epilepsy (centrotemporal spikes)

Temporal lobe epilepsy


Spikes confined to the left temporal region

A 16 year old girl presents after having a generalized tonic-clonic seizure. She has noticed that,
when she brushes her teeth or combs her hair in the morning, she occasionally experiences a brief,
involuntary jerk in her upper extremities. Past medical history is otherwise unremarkable. Her father
was also diagnosed with epilepsy as a teenager, and remains on antiepileptic medication. Exam is
normal, an EEG, shown below.
Which of the following statements about the genetics of this syndrome is true?
A) This syndrome is associated with an abnormality on chromosome 9

B) This syndrome is associated with an abnormality on chromosome 16

C) This syndrome is associated with an autosomal dominant inheritance pattern

D) This syndrome is associated with an X-linked dominant inheritance pattern.

E) This syndrome is associated with an abnormality on chromosome 3

Generalized polyspike and waves in Juvenile Myoclonic Epilepsy

10 year with behavioural disorder falling down frequantly and abnormal writting
Describe the eeg
Diagnosis

Recurrent paroxysmal burst of high voltage slow wave activity


at regular intervals. Periodic complexes
SSPE

This EEG was recorded from an awake pediatric patient. What clinical features is this child most
likely to have?
A) Episodes of mouth twitching, drooling and speech arrest on awakening at night

B) Absence seizures

C) Mental retardation

D) Hemiballismus

E) Tremor

C hyptharrthymia ass with developmental delay and infantile spasm west syndrome

This is the EEG from a 10-year old patient in the ICU. He is intubated and unresponsive. What is the
diagnosis?
A) Locked-in syndrome patient

B) Absence epilepsy
C) Normal EEG

D) Benign rolandic epilepsy

E) Alpha coma

An 8 year old girl presents to your office accompanied by her parents. The parents state that she has
been having frequent staring spells. Past medical history is otherwise unremarkable. There is no
family history of seizures. Exam is normal.
Describe EEG?
Of the following options, which agent is the best choice as a first-line monotherapy treatment?
No treatment is indicated
Phenytoin
Gabapentin
Carbamazepine
Ethosuximide

Ans E absence seizure

EEG of a 16-year-old comatosed patient

Encephalopathy

A 6 year old boy presents to your office. The parents state that the child has been having frequent
staring spells. Past medical history is otherwise unremarkable. There is no family history of seizures.
Exam is normal. You obtain an EEG, which shows the following finding:
Which seizure types are most frequently seen in this child's epilepsy syndrome?
A) Focal motor, generalized tonic-clonic, and myoclonic

B) Generalized tonic-clonic, complex partial, and absence

C) Absence, myoclonic, and generalized tonic-clonic

D) Generalized tonic-clonic, gelastic, and absence

E) Generalized tonic-clonic, absence, and infantile spasms