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Flashcards in Abnormal EEGs Deck (23)
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1
Q

What is the difference between photoparoxysmal response and photoconvulsive response?

A
  • Photoparoxysmal response = Generalized spike-wave discharges without clinical correlation
  • Photoconvulsive response = Generalized spike-wave discharges with a clinical response
2
Q

What is shown on this EEG and in what conditions can it be seen?

A
  • Alpha coma (note lack of reactivity)
  • Can be seen with anoxic brain injury (signals poor outcome)
  • Can also be seen with head injury, brainstem stroke or TME
3
Q

What is a photomyoclonic (photomyogenic) response?

A

Widespread muscle twitching timed to the stimulus representing an elevated brainstem-mediated reflex

4
Q

Difference between spikes and sharp waves in relation to distance from the cortex

A
  • Spike occur from synchronous depolarization of neurons within 6 cm of the cortex
  • Sharp waves occur from synchronous depolarization of neurons further away from the cortex
5
Q

What is the progression of EEG changes seen in CJD?

A
  • Intermittent diffuse slowing
  • Periodic sharp wave complexes
  • More continuous diffuse slowing with periodic sharp complexes
  • Loss of periodic sharp complexes with continuous slowing
6
Q

In the setting of an intracranial tumor what does focal delta and or theta activity correlate with?

A

White matter involvement by the tumor

7
Q

In the setting of an intracranial tumor IRDA suggests what?

A

Involvement of the thalamus or frontal deep white matter

8
Q

In the setting of an intracranial tumor, background attenuation suggests what?

A

High grade glioma with thalamic involvement or with extensive peritumoral edema

9
Q

FIRDA in adults suggest what?

A

It suggests acute or subacute diffuse cortical or subcortical gray matter dysfunction

10
Q

Classic EEG abnormalities seen in Landau-Kleffner Syndrome

A

Spike or sharp wave activity with slow waves initially seen only during NREM sleep

11
Q

Clinical picture of Landau-Kleffner Syndrome

A
  • 3 - 10 years old with normally acquired language
  • Develops auditory verbal agnosia (inability to comprehend speech)
  • Infrequent nocturnal partial or secondarily generalized seizures
12
Q

What is the clinical picture of SSPE?

A
  • Ages 5 - 15 years old
  • After a primary measles infection
  • Progressive psychoneurological deterioration including personality changes and seizures
13
Q

Diagnosis?

A

SSPE

14
Q

EEG pattern in Subacute Sclerosing Panencephalitis

A

Periodic complexes composed of high amplitude, bisynchronous and symmetrical polyspike and sharp and slow wave complexes occuring every 4 to 15 seconds

15
Q

Common causes for lateralized PDs (formerly PLEDs)?

A

HSV encephalitis

Acute/subacute stroke

Seizures

16
Q

Periodic discharges are found in what percent of patients with CJD?

A

Approximately 60%

17
Q

What is the most specific CSF test for CJD?

A

RT- QuIC

(Real Time Quaking Induced Conversion)

18
Q

What does the downward green angle in the frontal head region represent?

A

Eye closure

19
Q

Diagnosis?

A

PLEDs

seen in subacute strokes, HSV encephalitis, brain abscess or after a run of seizures

20
Q

Diagnosis?

A

Hypsarrhythmia

note disorganized background with multi focal spikes

21
Q

Diagnosis?

A

Centro temporal spikes

as seen in benign rolandic epilepsy

(different example below)

22
Q

Diagnosis?

A

Photoparoxysmal response

  • Outlasts photic stimulation
  • Strong association with generalized epilepsies, especially JME
  • Can sometimes see with alcohol or benzo withdrawal
  • (another example below where activity outlasts photic stim by a few milliseconds
23
Q

What is the general interpretation of photoparoxysmal response?

A
  • It has a clinical correlation with photosensitivity and generalized epilepsy
  • It can be an inherited disorder and not associated with epilepsy
  • PPR beyond photic stimuli more frequently associated with epilepsy