First seizure, 70+ Jul 22, 2025

The patient had an episode of amnesia yesterday. He recalls seeing flashes of multi-coloured "circles and squiggles on the left" and then recalls telephoning his wife, who was not at home. He has no r...

Continue Reading...
A colleague's question Jul 21, 2025

Re this post, Frontal lobe seizures versus functional seizures? Teenager
A colleague asks, "could this be phantom spike-and-wave?"

 

The short answer is no. Why? Phantom spike-and-wave (also known as...

Continue Reading...
Right frontal versus temporal sharp and slow wave? Jul 20, 2025

When reading on the common average montages, I am often reminded of the quote by WS Gilbert, "Things are seldom what the seem".

 

Take a look at the following page.

 

 

The discharge correspond...

Continue Reading...
Low amplitude spike and wave don't mean it ain't an IED Jul 19, 2025

Part of the vaccine against the (false positive) spike protein on the EEG is the use of amplitude as a criterion. However, no criterion is absolute, but in disregarding it you need to be very, very, v...

Continue Reading...
Arousal, resembles a seizure Jul 18, 2025

The asymmetry of the following rhythms during transient arousal resembles a seizure at T4-T6. The following are three consecutive pages.

 

 

 

 

In contradistinction to a seizure, the above...

Continue Reading...
Frontal lobe seizures versus functional seizures? Teenager Jul 17, 2025

The EEG is normal during wakefulness. What do you make of the following discharges during sleep?

 

The epoch is taken from sleep:

 




Here is the above page, represented on the anterior-posterior bi...

Continue Reading...
Six years old, encephalopathy? Jul 17, 2025

What you make of the following three consecutive pages of the EEG?

 

Figure 1.

 

 

Figure 2: This follows the previous page.

 

 

Figure 3.

 

 

 Here are a few other pages from the sam...

Continue Reading...
Triphasic waves vs spikes Jul 16, 2025

If you want to start an argument, wading into the territory of triphasic waves is sure to have the desired effect! Some authors suggest that spikes and triphasic waves rarely coexist, but I doubt that...

Continue Reading...
Who should interpret routine EEGs? Jul 14, 2025

This is from a survey performed in the USA:

Journal of Clinical Neurophysiology

 

 

Continue Reading...
7y Jul 14, 2025

As a sequel to the case posted on Friday (13y, Friday Frown), have a look at the following waves in sleep. 


Figure 1:

 

In figure 1 above there are spikes at T4-C4 (red vertical lines) and vertex...

Continue Reading...
13y, Friday Frown Jul 11, 2025

Have a look at the following pages: the patient is initially awake and later asleep. Do you see any abnormalities during wakefulness or sleep?

 

Figure 1. Awake:

 

 

Figure 2. Awake, the eyes a...

Continue Reading...
Rhythmic occipital waves, 10y Jul 10, 2025

One doesn't see the following waves very often:

 

 

In the above page, the occipital rhythmic delta waves are seen on the left, but in the following examples these are seen bilaterally;

 

 

...
Continue Reading...
1 2 3 4 5 6 7 8