Scratch your head about this one

This is an adult, reclining with his head above the pillow and reading on his cell phone. The history indicates that he most likely has Genetic Generalised Epilepsy (GGE, also known as idiopathic generalized epilepsy).

The discharge may be mistaken for a series of spikes or even an electrographic seizure over the occipital regions.

The first component of each wave is unusually sharp for the spike in a spike-and-wave discharge. This atypical morphology should raise a red flag. The waves are high in amplitude at O2 and 01, but do not involve the contiguous derivations; that would be unusual for occipital seizures or spike-and-wave. Thinking that I would find him tapping on his head, I turned the video on, to find that he was rhythmically scratching the back of his head. The scratching movements coincided with the artefact. This is yet another example of "pseudo-spike-and-wave"" or a "pseudoseizure" consequent upon an artefact.