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Patti Baumgartner, R. EEG/EP., CNIM. Danny Glover Sir Isaac Newton Pope Pius IX Socrates Napoleon Charles Dickens maybe someone you know?

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Presentation on theme: "Patti Baumgartner, R. EEG/EP., CNIM. Danny Glover Sir Isaac Newton Pope Pius IX Socrates Napoleon Charles Dickens maybe someone you know?"— Presentation transcript:

1 Patti Baumgartner, R. EEG/EP., CNIM

2 Danny Glover Sir Isaac Newton Pope Pius IX Socrates Napoleon Charles Dickens maybe someone you know?

3 They all have epilepsy.

4  It is estimated that at least 2/3 of seizures occur in sleep.  Not everyone who has a seizure has epilepsy  Some seizures can hardly be noticed, while others are totally disabling.

5  A seizure is a sudden surge of electrical activity in the brain that usually affects how a person feels or acts for a short time.  Seizures are not a disease in themselves. Instead, they are a symptom of many different disorders of the brain.  Not everyone who has a seizure has epilepsy.

6  Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions.  When a person has 2 or more unprovoked seizures they are considered to have epilepsy.

7  Any one of us can have a seizure if the conditions are right.  Drugs  Hypoglycemia  High fever  ECT  Infectious disease Meningitis/encephalitis



10 Plan for the future Solve complex problems Express and control emotional behavior Coordinate complex skilled movements Some aspects of speech

11  In most people the temporal lobes have somewhat different functions The left temporal lobe generally helps us to understand language, and speak. The right temporal lobe helps us to remember things.

12 Includes sensory areas, responsible for feelings of temperature, touch, pressure and pain.

13 Primary function is vision

14  Seizures are classified into 2 categories or groups:  Partial and Generalized

15  Involve only a portion of the brain at the ONSET.  They are further divided into two parts:  Simple partial, in which consciousness is not impaired  Complex partial in which consciousness is impaired.

16  These seizures are commonly called grand mal. And by definition begin with loss of consciousness.  Typically each seizure has 2 phases, tonic and clonic.  Tonic Phase consists of an increase in muscle tone which causes stiffening.  Clonic Phase consists of alternating tightening and relaxing of muscles--Jerking

17  Another type of generalized seizure is the Atonic Seizure.  The seizure consists of loss of all strength rather than becoming stiff. They last only a few seconds so it is impossible to accurately determine the patient’s level of consciousness.

18  Brief episodes of staring. May have some associated eye blinking/fluttering, or lip smacking.  Spells last only a few seconds  Start in Childhood, disappear by late teens

19 Seizures that begin with an abnormal electrical discharge from a limited area of the brain are called partial seizures. Two kinds: Simple complex Partial Complex

20  The specific area of he brain where each of these seizures begins determines what the seizure looks like.  Commonality is that the person having the seizure remains alert and can remember what happened.  Sometimes called focal seizures

21  These seizures begin in a small area of the temporal or frontal lobe, but they quickly involve areas that affect alertness and awareness  Consciousness is lost, the patient has no memory of the event

22  Both simple and complex partial seizures can spread, resulting in secondarily generalized tonic clonic seizures.  In the EEG world this is called secondary subcortical synchrony

23 Rebecca Clark-Bash23 Summary of Clinical & EEG Features of Epileptic Seizures SeizureUsual Duration Loss of Consc. Post-Ictal Confusion ICTAL EEG Simple Partial 5-10 secNO Focal Spikes (NL) Complex Partial Variable 5-10 sec 1-2 min YES Focal or Lat. Spike Absence 5-10 /sec Clustering YESNO Gen. 3 /sec S & W Gen. Tonic-Clonic 1-2 minYES Gen. High Amp Spikes

24 Tegretol Carbatrol Zarontin Felbatrol Gabitril Keppra Lamictal Lyrica Dilantin Topamax Trileptal Depakene Depakote

25 Rebecca Clark-Bash 25 Term Definition  Ictal EEG Describes the recording during the event  Interictal EEG Describes the recording in between each event  Postictal EEG Describes the period of time immediately following an event

26 Any paroxysmal rhythmic frequency (e.g. beta, alpha, or even delta) may also be classified as epileptiform. Certainly the most common types of Epileptiform activity are: spikes, sharp waves, spike and waves

27  A wave with a duration of 80 msc or less, usually negative, standing out from the background.

28  A wave with a duration of 120-80 msc, usually negative, standing out from the background.


30  Spike followed by a slow wave

31 31 What do you see on the EEG The signature of epilepsy: “cat”



34  Eye Blink artifact



37  Asymmetrical Alpha. Alpha activity is higher amplitude on the



40  Generalized spike and wave



43  Multifocal Spikes



46  C4 spikes



49  Generalized Spike and Wave



52  Generalized Polyspike and Wave



55  Focal slow F7 T3



58  Focal Slow, best seen on slow paper speed

59  Bernard M. Abrams, M. D.  Susan Gersh, R. EEG T.  Rebecca Clark Bash, R. EEG/EP T., CNIM, F.ASNM  Terry O’Brien

60  1. Eye Blink  2. Asymmetrical Alpha  3. Generalized Spike and Wave  4. Multifocal Spikes  5. C4 focal Spike  6. Generalized spike and wave  7. Generalized Polyspike and wave  8. Focal spikes F7 and T3  9. Focal slowing T3 best seen on Sleep Parameters (slow speed)

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