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Given the low to moderate sensitivity, a routine EEG (typically with a duration of 20–30 minutes) can be normal in people that have epilepsy. When an EEG shows interictal epileptiform discharges (e.g. sharp waves, spikes, spike-and-wave, etc.) it is confirmatory of epilepsy in nearly all cases (high specificity), however up to 3.5% of the ...
A spike-and-wave discharge is a regular, symmetrical, generalized EEG pattern seen particularly during absence epilepsy, also known as ‘petit mal’ epilepsy. [1] The basic mechanisms underlying these patterns are complex and involve part of the cerebral cortex , the thalamocortical network , and intrinsic neuronal mechanisms.
Seizures appear on the trace as regions of high activity with a raised and compacted trace in the aEEG pane; this would correspond to high-amplitude, repetitive waveforms in the non-integrated pane. A low-amplitude or 'suppressed' trace is prognostically concerning as it indicates abnormally low brain activity.
A paper published in 2023 showed that burst suppression and epilepsy may share the same ephaptic coupling mechanism. [6] When inhibitory control is sufficiently low, as in the case of certain general anesthetics such as sevoflurane (due to a decrease in the firing of interneurons [7]), electric fields are able to recruit neighboring cells to fire synchronously, in a burst suppression pattern.
Forced Normalization (FN) is a psychiatric phenomenon in which a long term episodic epilepsy or migraine disorder is treated, and, although the electroencephalogram (EEG) appears to have stabilized, acute behavioral, mood, and psychological disturbances begin to manifest.
The scalp EEG, while a valuable diagnostic tool, lacks the precision necessary to localize the epileptogenic region. ECoG is considered to be the gold standard for assessing neuronal activity in patients with epilepsy, and is widely used for presurgical planning to guide surgical resection of the lesion and epileptogenic zone.