Diagnostic Sensitivity

An awake standard EEG record will record IEDs in ~50% of adults with epilepsy.12 The chance of recording IEDs increases with multiple EEGs and it is 92% with four recordings.19 The yield substantially increases by recording during sleep, more so after overnight sleep deprivation.20,21 Sleep recordings are of special value for ascertaining focal IEDs in partial epilepsies22,23 and establishing the presence of generalized IEDs in patients with idiopathic generalized epilepsy syndromes.12,13 A single wake and sleep EEG provides information supportive of diagnosis and also

Dystonic Posturing Seizures

Figure 1. EEG - MRI - video-EEG correlation in a patient with medically refractory temporal lobe epilepsy. Shows (A) right anterior temporal spike discharges; (B) small right hippocampus on T1 -weighted coronal MRI sequence; (C) dystonic posturing of the left upper extremity during video recorded complex partial seizure; and (D) rhythmic right temporal EEG activity during the seizure.

Figure 1. EEG - MRI - video-EEG correlation in a patient with medically refractory temporal lobe epilepsy. Shows (A) right anterior temporal spike discharges; (B) small right hippocampus on T1 -weighted coronal MRI sequence; (C) dystonic posturing of the left upper extremity during video recorded complex partial seizure; and (D) rhythmic right temporal EEG activity during the seizure.

Temporal Complex Partial Seizures Eeg

Figure 2. Right temporal intermittent rhythmic delta activity (TIRDA) in a patient with medically refractory complex partial seizures.

Figure 2. Right temporal intermittent rhythmic delta activity (TIRDA) in a patient with medically refractory complex partial seizures.

classification of epilepsy in -80% of patients.12,13,16 Temporal intermittent rhythmic delta activity (TIRDA) consists of trains of rhythmic, sinusoidal 1-4 Hz activity of 50-100^V in amplitude lasting 3 seconds or more in duration and occurring more frequently during drowsiness and light sleep and has a high diagnostic specificity for temporal lobe epilepsy (Fig. 2).24,25 The frequency of IEDs in elderly persons with epilepsy is substantially low when compared to the frequency reported in the epilepsy population as a whole.26

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