Spike and wave?

Consider the following page;

Although the discharges resemble spike-and-wave, if you look backwards or forwards in the top 2 channels, you will recognise similar sharply contoured waves. These represent extraocular eye muscle movement artefacts. Hence, the temporal association of the "spike" and the slow wave is spurious. The discharge consisting of a burst of generalised theta and delta waves is abnormal but does not represent spike-and-wave or an inter-ictal epileptiform discharge. The abnormal discharge is "non-specific", which means that, while abnormal, is not specific to any one condition. Hence, when doing the clinical interpretation, consider the history that you have been provided in determining the likely cause(s) for the EEG abnormality, but avoid misleading statements like "this could support the diagnosis of epilepsy". In addition to other reasons, diagnostic tests are generally done to determine the probability of a particular diagnosis (best quantified by the "likelihood ratio"). The above abnormality is not likely to materially change the probability of epilepsy versus other conditions under consideration. However, if the patient undoubtedly has epilepsy, the findings favour a diagnosis of generalised epilepsy over the possibility of focal epilepsy. This conclusion is contingent on the presence of epilepsy, not in arriving at a diagnosis of epilepsy. The distinction is important.