A novel solution to a common problem? Sep 03, 2025

F7 and F8 are 2 of the electrodes that are most prone to come adrift during prolonged recordings. There are various ways to deal with this problem when reviewing the recording, which can look even mor...

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Arising from the background Sep 01, 2025

Do the following represent alpha rhythms that are propagating anteriorly? Or is this drowsiness? Could these waves be spikes? Could this be a benign phenomenon?

 
figure 1:

 

 Figure 2:

 

 Fig...

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Seizures are primarily about neurophysiology and not about neuroradiology Aug 30, 2025

Medial temporal sclerosis (or mesial temporal sclerosis) is essentially a pathological diagnosis; high quality MRI scans interpreted by experts who work in the field are strongly predictive of the pat...

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Suppression of EEG rhythms Aug 28, 2025

This discussion related to an EEG performed on someone in ICU refers ICU, "Not waking up, seizures? Brain dead?"

 

To reiterate, judgements about suppression can be quite tricky, doubly so in the ...

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Scratch your head about this one Aug 27, 2025

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 gene...

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ICU, "Not waking up, seizures? Brain dead?" Aug 26, 2025

This is a common problem. What would you tell the clinician in your clinical interpretation about the EEG?

 

Figure 1. Bipolar anterior-posterior montage, 7 µV per millimetre:

 

 

 

Figure 2. ...

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Bursts of theta (v1) Aug 24, 2025

The following is a common phenomenon. The million-dollar question is, what is its significance? Attempt to arrive at your own conclusion, before reading my thoughts at the bottom. To reiterate, mine a...

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Age: 20+; dissociative seizures Aug 17, 2025

Have a look at the following few pages, which follow one another. These occur at the time of a dissociative seizure. What do you make of the 9-10 Hz alpha frequencies over the frontal regions? Do you ...

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Spike-and-wave morphology Aug 15, 2025

This adult is asleep, and the conclusion seems pretty straightforward, doesn't it?

 

The wave has a "field" and a spike morphology, followed by a typical slow wave that is in the same distribution...

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Small sharp spikes, further comment and case Aug 13, 2025

Roland made the point at the bottom of this post Small sharp spikes; wading into the controversy. that small sharp spikes are often missed on bipolar montages and are particularly noticeable on refere...

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F-wave vs V-wave vs generalized spike vs left frontal spike vs other? Aug 11, 2025

The patient is 30+ years old and asleep.

 

What do you make of the following wave that occurs between the 7th and 8th ECG beats?

 

 

The following represents the same epoch on the coronal monta...

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Red Alert 4 Aug 05, 2025

This young adult is asleep at approximately 02h00. The differential diagnosis is of epilepsy and non-epileptic seizures/functional seizures. 

 

 

Using the criteria of morphology and field, you m...

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