CAUTION Sustained focal slowing without centrotemporal spikes or diffuse slowing consider other epilepsy syndromes.. Interictal. Interpretation: Do not know why EEG ordered, or clinically whether you suffer neurological symptoms, so will answer generically. One study found nor-mal fluctuations of the alpha rhythm (Figure 4) to be the most common reason for misidentifying EDs on the EEG, most of which were identified Figure 2. and occasional spread of the discharge to the right frontal and occipital areas. b. from photomyogenic response. The EMG is most likely originating _____. A slow wave may occur focally, such as in the left anterior temporal area or the right occipital area. Marked spikes and sharp waves etc. The combination of slow and sharp waves together, compared with only one type of EEG abnormality, was associated with more clinical neurological symptoms, especially a mental status change. "triangular" or V-shaped wave that are particularly prominent in light sleep (see Figures 11-1 and 11-2). Temporal lobe sharp wave activity has a high correlation with clinical seizures. The interictal EEG showed sharp waves on left temporal region only during NREM and REM sleep. Term (40 weeks): Frontal sharp waves can be seen during . About a week and a half ago my perfectly healthy son went from one minute being okay to suddenly screaming about pain in his left hand and then started jerking his head, stopping, hands shaking, stopping, legs jerking . EEG abnormalities (spike-and-wave or sharp slow waves) are seen in an anterior temporal distribution in mesial temporal lobe structural brain abnormality. Rare right temporal sharp waves also occurred during sleep (~5 waves/h). On the basis of a high index of suspicion for occult seizures, the patient was implanted with bilateral FO elec- Figure 1 Case group with 60 subjects, 15 males and 45 females with sharp slow-wave in left temporal region on EEG. The most obvious descriptor of a slow wave . What does an abnormal EEG, "due to intermittent focal slowing occurring independently from the left and right temporal regions with the left side predominance." mean? 177. On two occasions Focal slow wave activity on the EEG is indicative of focal cerebral pathology of the underlying brain region. Left greater than right temporal sharp waves to theta range. It may have an abnormal frequency, height or shape. This is the distribution of abnormal EEGs with regard to the severity of abnormalities. A variety of etiologies for focal cerebral dysfunction may be seen. Several seconds later, a rhythmic right temporal discharge appeared. Other findings include delta brushes, frontal sharp transients, and theta bursts. 'sharp' waves often appearing in the temporal and frontal regions [23]. left temporal transients consistent with a breach and a photocell artifact; • AH is 70 years old and presented with several weeks of dizziness, headaches and falls. [ncbi.nlm.nih.gov] Early Infantile Epileptic Encephalopathy Type 3 Temporal Theta and Alpha Bursts. Lennox-Gastaut Syndrome. Interictal. over the anterior left temporal channels, with. If seen in a patient with reasonably high suspicion of a seizure, the predictive value of spikes and sharp waves for epilepsy is high . Spike-driving during low-frequency photic stimulation in a normal individual referred Spikes or sharp waves are terms commonly seen in EEG reports. Spikes or sharp waves are terms commonly seen in EEG reports. (The red arrow represents the origin of the seizure; the black arrow represents the starting point of the IPS.) The other way an EEG can show abnormal results is called non-epileptiform changes. This area shows activity when healthy individuals perform stem completion tasks, for example, a task that requires completing the word stem "cou-." The area does not show activity in simpler language tasks such as word reading. The EEG is a unique measure of electrical brain function and is widely used in patients with seizures. In control group we had 70 subjects, 30 males and 40 females with normal EEG (Figure 2). In the waking EEG the specificity of these so called epileptiform EEG phenomena is indeed quite high. Spike count done showed 75% predominance of the spikes and sharp waves in the left temporal lobe and 25% in the right temporal lobe. The classic EEG finding in this childhood seizure disorder is a characteristic monomorphic centrotemporal sharp wave. f. Sharp waves and spikes must deviate from the background pattern. • Usually means EEG reader saw either sharpUsually means EEG reader saw either sharp waves, spikes, or slow waves • DOES NOT MEAN THE PATIENT IS ACTUALLY SEIZING DURING THE EEG! (EEG . Also have severe headaches said to be migraines but start at base of skull/top of spine and have small blind areas to outside regions of vision (constant, not just with headaces). Download scientific diagram | A patient with temporal lobe epilepsy: EEG showed left temporal spikes and sharp waves with phase reversal. Overview. On continuous video-EEG monitoring, left temporal sharp waves were seen at a rate of ~2 waves/h during wakefulness and ~40-70 waves/h during sleep. Spikes from the mid-temporal and posterior temporal leads were less . Spikes/sharp waves should have sufficient amplitudes to distinguish them from the background, such as by a factor of two. A routine 16-channel EEG was moderately to markedly abnormal, focal, and paroxysmal with frequent bursts of high amplitude sharp waves, spikes, and spike-waves in the right temporal re- gions. May 14, 2011. Many normal variants and variations of normal EEG have a predilection for the temporal lobe and mimic epileptiform discharges. Sources of the underlying cortical generators of the vertex sharp wave were modeled using Two Dimensional Inverse Imaging (2DII) [3] and MR-FOCUSS [4]. In patients evaluated for suspected epilepsy, the presence of unequivocal sharp waves, spike-waves or poly spike-and-wave paroxysms in the scalp EEG is considered to provide strong support for the clinical diagnosis. 2) Identify temporal intermittent rhythmic delta activity (TIRDA) and understand . Fifty-nine partial seizures were . Term and pediatric EEG. Despite the history, she was diagnosed with seizures and started on antiepileptic drugs. In adult patients, most of the misread patterns are temporal lobe sharp wave or spike mimics. Results - MRI showed left hippocampal sclerosis. Sharp wave: Duration of 70-200 milliseconds No difference in etiology or prognosis between a spike or sharp wave Clinical relevance. High amplitude centrotemporal spikes or sharp-and-slow wave complexes that activate in drowsiness and sleep are mandatory. If these happen only once in a while or at certain times of day, they may not mean anything. Ictal scalp video EEG showed left temporal rhythmic sharp waves after the clinical onset of epigastric aura, followed by staring. Correlations: Brain trauma can eventuate with post-traumatic epilepsy, and the question of possible seizure activity is supported by a focal eeg abnormality c/w seizures.Your physician can pull all of this together, and i cannot confirm whether your possible szs. Slowing may be intermittent or persistent, with more persistent or consistently slower activity generally indicating more severe underlying focal cerebral dysfunction. Overview. 0. [epilepsydiagnosis.org] Electroencephalogram (EEG) showed background slowing of about 7 Hz, multifocal spike and wave, and generalized spike and wave complex-es (1.5 3.5 Hz). One study found nor-mal fluctuations of the alpha rhythm (Figure 4) to be the most common reason for misidentifying EDs on the EEG, most of which were identified Figure 2. To ensure the reliability of ABNORMALITIES OF SLOW-WAVE (DELTA AND THETA) ACTIVITY Descriptive Parameters for Slow Waves. These If they happen frequently or are found in specific areas of the brain, it could mean there is potentially an area of seizure activity nearby. Fig. Most show: abnormal eeg due to bitemporal independent slowing, indicating focal neuronal dysfunction. 1 increased left temporal; Dysrhythmia gr. Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for short-term memory. c. from focal twitching of the right wrist. Epileptiform transients such as spikes and sharp waves are the interictal marker of a patient with epilepsy and are the EEG signature of a seizure focus. Left temporal polymorphic delta. Discordant imaging and scalp EEG data led to an invasive evaluation with bilateral subdural strip and depth electrodes (6 subdural electrodes over frontal, frontoparietal, and temporal regions on each side and 3 depth . The sharp wave or spike is produced by an abrupt change in voltage polarity that occurs over several milliseconds. Is this a diagnosis of Epilepsy? EEG features Ictal EEG findings Clinical onset preceded EEG onset. • Usually means EEG reader saw either sharpUsually means EEG reader saw either sharp waves, spikes, or slow waves • DOES NOT MEAN THE PATIENT IS ACTUALLY SEIZING DURING THE EEG! Temporal slowing just means that the brain waves in that area are slower frequency than would be expected. from publication: Childhood temporal lobe epilepsy . a. from facial and eye twitching and jerking. Scalp video EEG interictally demonstrated left temporal spike and sharply contoured slow waves, and right fronto-centro- temporal spike and waves. The high prevalence of temporal lobe epilepsy and the propensity for normal variants to occupy the temporal lobe may result in an undesired bias, leading to . . was observed only in 8%. In healthy adults, spikes and sharp waves are seen in about 0.5-1%. The background must be normal, with the presence of normal sleep architecture. During LTM, we recorded three electroclinical seizures, two of them arising from sleep and one during wakefulness, characterized by ICA for around 17 s before any other clinical manifestation ( Figure 1 ). Interictal EEG Left (sharp waves) Left mesial temporal Ictal EEG Left Temporal ESI Left Mesial Temporal MRI Left Nl volumetric analysis Increased T2 FLAIR in the area of CA4 of left HC fMRI Left language PET/CT Left Subtle left temporal anteromedial hypometabolism Ictal SPECT Left Temporal ally recorded during either standard or video EEG. Interictal EEG typically shows temporal sharp waves maximum at anterior or mid temporal electrodes. They consisted of brief, recurrent runs (<2 seconds) of theta activity that were usually intermingled with sharp waves over the left anterior temporal derivation. EEG revealed diffuse and slow activities with periodic sharp-wave complex discharges seen in the right parietal, temporal and occipital lobes. Sharp wave, left temporal region. 8/19/2010 Template copyright 2005 www.brainybetty.com 38 ACTUALLY SEIZING DURING THE EEG! I am a 26 year old female who suffers from (as one of the neurologists I see said) "sharp spike waves in the left temporal lobe." I also suffer from dysautonomia (dysregulation of the autonomic . Note the run of sharp wave discharges evident phase reversal at F7. Mean age was 54.1 ± 8.2 years. Start test. Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings — such as euphoria, deja vu or fear. This is the distribution of abnormal EEGs with regard to the severity of abnormalities. Scalp EEG during prolonged video-EEG monitoring revealed sharp waves localizing to the right anterior temporal region, with phase reversals at the right sphenoidal electrode maximal at T8 (Fig. The EEG groups were divided into four types of findings of slow and sharp waves, appearing in at least a first and/or second record. d. from generalized tonic clonic activity. Hello everyone, I am new to the forum and I am looking for some ideas in regards to treatment for Left Temporal Lobe Seizures. At seizure onset, the EEG was contaminated by movement artifact. waves in the temporal region during drowsiness or light sleep in older adults Arciform or wicket like, occasionally isolated wicket spikes Can be unilateral or bilaterally asynchronous Absence of a following slow wave and the normal EEG activity before and after the spikes differentiates them from epileptiform spikes. c. Sharp waves and spikes must have a definable electrical field. 2.1.2. Onset of the ictal discharge in the left temporal lobe A useful developmental EEG marker is the appearance of rhythmic 4 to 6 Hz waves occurring independently in short bursts of rarely more than 2 seconds arising independently in the left and right midtemporal areas. Fronto-temporal lobar dementia (FTLD) It is usually said that the EEG is normal in FTLD. Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for short-term memory. Voltage varies from roughly 20 to 200 µV. The delta activity varies from second to second and each wave looks different than those around it, making it polymorphic. The purpose of this study was to describe the characteristic EEG findings in a group of cases of DLB confirmed by postmortem, specifically looking for evidence of focal abnormalities in the temporal lobes, or for triphasic or sharp waves, and to compare these records with those from cases of SDAT confirmed by postmortem. 8/19/2010 Template copyright 2005 www.brainybetty.com 38 ACTUALLY SEIZING DURING THE EEG! Usually electrical activity in the outer three layers of the gray matter (cortex) of the brain s detected on EEG. The whole brain shows it in generalized seizures. After her EEG showed 'ongo-ing temporal lobe seizures', she was treated with multiple AEDs. Muscle artifacts usually can be easily identified by their much higher frequency component, provided an appropriate high-frequency filter be chosen. The referential montage (right panel) confirms that the maximum is at electrode T2, followed by F8 and T4. >32 weeks: Trace alternant replaces trace discontinu; High-voltage bursts are separated by low-amplitude voltage waves. Figure 2.The ictal EEG of left temporal onset focal seizure induced by IPS in patient 1 (A-E) the initial 1.5-2-Hz slow waves in the left anterior and mesial temporal area → the spikes mixed waves, and then medium amplitude delta waves in the left temporal area. Multiple monophasic vertex waves are often identified on EEG recordings. Spike-driving during low-frequency photic stimulation in a normal individual referred (ABSTRACT TRUNCATED AT 250 WORDS) Publication types English Abstract MeSH terms Adult Aged Dominance, Cerebral The maximum of abnormal activities was over frontal and temporal areas. So it is a totally non-specific finding, but suggest a focal problem. EEG filters should be used carefully. showed left and right sphenoidal sharp waves, and complex partial seizures EEG onset in the left sphenoidal electrode.