EEG Patterns in Generalized Epilepsy

Isra Ikhwama M 1*, Nazli Ferdian M 1, Hastuti Sri 2

1
Residen Bagian Neurologi Fakultas Kedokteran Universitas Syiah Kuala/ RSUD dr.Zainoel Abidin

Banda Aceh

2
Staf Pengajar Fakultas Kedokteran Universitas Syiah Kuala Banda Aceh

Short Title: EEG Patterns in Generalized Epilepsy

*Corresponding Author

Isra Muhammad

Neurology Department

University of Syiah Kuala/RSUD dr. Zainoel Abidin

Jl. Malikulsaleh 1 No 7 Kota Baru, Kec Kuta Alam, Banda Aceh, Aceh, Indonesia 23125

Tel: +6285360082069

Fax: -

E-mail: isradokter01@gmail.com
 EEG Patterns in Generalized Epilepsy
Isra Muhammad Ikhwana 1*, Nazli Ferdian 1 , Hastuti Sri 1
1
Departement of Neurology, Faculty of Medicine, University of Syiah Kuala, Banda Aceh, Indonesia

Background : Most primary generalized seizures, the bursts of spike-and-wave activity

observed interictally in patients with idiopathic generalized tonic-clonic seizures typically
become more frequent with the onset of slow wave sleep. The transition period from
wakefulness to drowsiness is particularly important because, in some patients, this is the only
time spike-and-wave activity may appear in a routine EEG.(4)

Objective : Identify clinical features of signs, symptoms and characteristic of EEG pictures.

Case Report : A 24 years old woman who has got epilepsy for 12 year, Pre ictal no
preceding aura, in ictal her semiology of seizure both upper and lower limb tonic clonic
during 5-10 minutes and patient can not respon for the commands, produce saliva and urine
occasionally, lips and tounge were often bitten , seizure which occurs upon awakening
during activity or intermission , Post ictal she slep for 1-2 hours. The freuency around 3-4
times per month, History of medication : fenitoin, twice a day, the consums the medication
not regularly.

Finding : During awake Interictal discharges showed burst generalized stereotype spike 1-
1,8 Hz occasionally 1-2 Hz and sometimes polymorphic spike mix sharp wave with high
amplitude in anterior frontal and anterior temporal. During sleep Interictal discharges
sometime showed generalized polymorphic spike (occasionally sharp ) wave in both frontal
and frontocentral, mid frontal, central and once or twice in left central and left parietal and
the focus epileptiform came from anterior left and right frontal. During hyperventilation,
Interictal epileptiform sometimes showed generalized polymorphic spike ( Occasionally
sharp ) wave in both frontal and frontocentral, mid frontal, and the focus epileptiform came
from anterior left and right frontal. The EEG indicate that the women It is has liability tend to
generelized epilepsy, and it correlate to the patient clinical.

Conclusion : The diagnosis of Generalized Epilepsy requires careful attention to history

supported by EEG. the bursts of spike-and-wave activity observed interictally in patients
with idiopathic generalized tonic-clonic seizures typically become more frequent with the
onset of slow wave sleep but in this case the bursts of spike-and-wave activity observed
interictally seen during awake and during hyperventilation.

Key word : Generalized epilepsy, Generalized tonic clonic seizure ( GTCS ), Eeg Pattern
Figure 1 : Background EEG showed PDR in
alpha range at 11-12 Hz which attenuation
upon eyes opening.
Figure 2 : During awake interictal discharges
showed burst generelized stereotype spike 1-
1,8 Hz occasionally 1-2 Hz and sometimes
interictal discharges burst generelized
polymorphic spike mix sharp wave with high
amplitude in F4 and F8
Figure 3 : During awake Interictal discharges
sometime showed generalized polymorphic
spike ( occasionally sharp ) wave in Fp1 > Fp2
> F3 > F4 > FZ > CZ and once or twice in C3, P3
and the focus epileptiform came from F3 and
F4.
Figure 4 : During Hyperventilation Interictal
epileptiform sometimes showed generalized
polymorphic spike ( Occasionally sharp ) wave
in Fp1 > Fp2 > F3 > F4 > FZ>CZ and the focus
epileptiform came from F3 and F4.
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