Are these seizures? The EEG is not conclusive but the CFM is suggestive of seizures.

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Presentation transcript:

Are these seizures? The EEG is not conclusive but the CFM is suggestive of seizures

Normal CFM and continuous EEG

Trace from infant with non ketotic hyperglycinaemia – note very amplitude CFM and frequent high voltage EEG bursts

Severe suppression of CFM with low voltage EEG bursts but no clear EEG seizure pattern

Severe suppression of CFM with low voltage bursts on EEG

Repetitive seizures – CFM hard to classify – often changes to severe suppression after treatment with anticonvulsants

Very suppressed CFM with bursts evolving to seizures

Probable seizure but EEG not characteristic – CFM has normal amplitude

Severe suppression of CFM with high voltage bursts on EEG

Variation in CFM amplitude possibly due to change in sleep/awake state; EEG moderately discontinuous

Artefact – CFM/EEG cannot be classified – initial part of trace appears normal

Very high voltage seizure discharge – CFM moderately suppressed

Probable movement artefact rather than seizure - CFM otherwise normal

Exaggerated sleep wake cycling pattern – common during recovery phase – note movement artefact with nursing care

Gross artefact - Note abnormal impedance in lower half of slide – CFM trace cannot be interpreted

Gross artefact probably due to detached electrodes Note abnormal high impedance in lower half of slide – CFM trace cannot be interpreted

CFM suspicious of frequent brief seizures but EEG not characteristic – full EEG exam needed

Rapidly recovering CFM trace – EEG initially moderately discontinuous

Initial very suppressed CFM – sudden increase in amplitude probably due to seizures

Severely suppressed CFM with some low voltage bursts on EEG and artefact due to handling of infant

Gross ECG artefact elevating CFM baseline – seizures are also present

Note seizures – CFM baseline elevated due to ECG artefact

Note ECG artefact causing elevation of CFM trace

CFM suspicious of intermittent seizure but not obvious on EEG

Probable pulse artefact which is abolished by change of position of head

Frequent seizures

Seizure on severely suppressed background with frequent low voltage bursts

ECG artefact resulting in CFM appearing falsely reassuring

Frequent high voltage sharp waves on EEG causing seizure like elevation of CFM

Normal continuous EEG activity and normal CFM with some sleep/wake pattern

Moderately abnormal CFM with artefact due to handling marked

Moderately abnormal CFM; note compressed scale of EEG trace

Normal trace initially – second half of trace has artefact

Normal amplitude with seizures

Severely abnormal trace with seizures

Severely abnormal trace with slow seizure discharge

Severely abnormal trace with frequent seizures in initially

Severely abnormal trace with seizures

Severely abnormal trace with high amplitude bursts

Moderately abnormal trace with burst suppression pattern improving initially

Moderately abnormal trace improving to a normal trace