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Figures for:
Pearls, Perils, and Pitfalls In the Use of the Electroencephalogram

[Semin Neurol 23(1):7-46, 2003. © 2003 Thieme Medical Publishers]


Figure 1. EEG of a 2-year-old child with very prominent spikelike vertex sharp transients.

Figure 2. EEG showing intermittent slow wave transients (*) in a 61-year-old subject.

Figure 3. EEG of an 8-year-old child with hemolytic anemia and uremia, showing paradoxical activation characterized by increased delta slowing induced by painful stimulation. (Reprinted from Markand ON. Electroencephalogram in metabolic encephalopathies. Electroencephalogr Clin Neurophysiol Suppl 1999;50:301-310; with permission from Elsevier.)

Figure 4. EEG of an 82-year-old patient with recent history of lethargy and confusion, showing frontal intermittent rhythmic delta activity. (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 5. EEG of a 69-year-old patient with hepatic encephalopathy, showing triphasic waves. (Reprinted from Markand ON. Electroencephalogram in metabolic encephalopathies. Electroencephalogr Clin Neurophysiol Suppl 1999;50:301-310; with permission from Elsevier.)

Figure 6. EEG of a 16-year-old comatose patient with Reye's syndrome, showing 14 cps positive spikes. (Reprinted from Markand ON. Electroencephalogram in metabolic encephalopathies. Electroencephalogr Clin Neurophysiol Suppl 1999;50:301-310; with permission from Elsevier.)

Figure 7. EEG of an 18-year-old patient with phenobarbital intoxication, showing generalized theta-delta activity with superimposed beta frequencies (A) followed in 3 days by normalization of the EEG (B). (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 8. EEG of a 49-year-old comatose patient following severe anoxic encephalopathy, showing bisynchronous periodic epileptiform discharges synchronous with jerks of the left lower extremity monitored on a separate channel.

Figure 9. EEG of a 75-year-old patient with severe anoxic encephalopathy, showing suppression-burst pattern. During the burst activity there is opening of the eyes; eye movements monitored in the last channel.

Figure 10. EEG of a 77-year-old comatose patient following cardiopulmonary arrest 4 days previously, showing "alpha coma pattern." Patient died after 2 days. (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 11. EEG of a 65-year-old patient with Herpes simplex encephalitis, showing periodic epileptiform discharges occurring over the right temporal region every 1 to 2 seconds.

Figure 12. EEG of a 16-year-old patient with subacute sclerosing panencephalitis, showing high-amplitude generalized periodic complexes repeating at intervals of 8 to 10 seconds and accompanied by eye jerks and myoclonic jerks of the upper extremities monitored on the last two channels. (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 13. Serial EEGs of a 62-year-old patient with Creutzfeldt-Jakob disease. The first EEG (A), obtained 2 months after the onset of dementia and progressive right hemiparesis, shows left-sided delta activity. EEG 2 weeks later (B) shows periodic lateralized epileptiform discharges over the left hemisphere, and an EEG taken 5 months after the onset of illness (C) shows typical bisynchronous high-amplitude periodic complexes superimposed on "flat" background. Myoclonic jerks monitored on the last channel are synchronous to the periodic complexes. (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 14. EEG of a 6-year-old patient with Batten's disease, showing high-amplitude spikes induced by photic stimulation at one per second. (Reprinted from Markand,[10] with permission from Lippincott Williams & Wilkins.)

Figure 15. EEG of a 43-year-old patient with right temporal glioma, showing polymorphic delta activity and low-amplitude spike discharges (*) over the right temporal region. (Reprinted from Daly and Markand,[61] with permission from Lippincott Williams & Wilkins.)

Figure 16. EEG of a 16-year-old patient with Sturge-Weber syndrome of the right hemisphere, showing total absence of rhythmic activities over the entire affected hemisphere. (Reprinted from Daly and Markand,[61] with permission from Lippincott Williams & Wilkins.)

Figure 17. EEG of a 47-year-old patient with a low-grade glioma of the left temporal lobe, showing slightly slow but higher amplitude alpha on the left side.

Figure 18. EEG of a 47-year-old patient with history of previous left craniotomy, showing breach rhythm in the left temporocentral region.

Figure 19. EEG of a 62-year-old patient with acute onset of right hemiparesis, aphasia, and right focal motor seizures, showing periodic lateralized epileptiform discharges over the right posterior temporal region.

Figure 20. An EEG of a 15-year-old patient with primary generalized epilepsy, showing prolonged (self-sustained) photoparoxysmal response.

Figure 21. EEG of a 46-year-old patient with primary generalized epilepsy, showing atypical generalized bisynchronous spike wave activity.

Figure 22. EEG of a 6-month-old infant with developmental delay and infantile spasms, showing typical hypsarrhythmic pattern.

Figure 23. EEG of a 5-month-old infant, showing electrodecremental response during an infantile spasm monitored on the last channel.

Figure 24. EEG of a 16-year-old child with mental retardation and tonic seizures, showing slow spike wave activity superimposed on a slow background.

Figure 25. EEG of a 7-month-old child, showing independent multifocal spike discharges.

Figure 26. EEG of an 11-year-old patient with Lennox-Gastaut syndrome, showing generalized paroxysmal fast activity (B).

Figure 27. EEG of a 68-year-old patient with a long history of complex partial seizures, showing a focus of sharp waves and low-amplitude slow activity over the right anterior temporal region.

Figure 28. EEG of a 9-year-old child with benign Rolandic epilepsy, showing a focus of right centrotemporal spike discharges. The right half of the figure shows a spike discharge with horizontal dipole distribution.

Figure 29. EEG of a 72-year-old patient, showing benign epileptiform transients of sleep (small sharp spikes).

Figure 30. EEG of a 26-year-old patient, showing 6 Hz spike wave paroxysms (phantom spike wave).

Figure 31. EEG of an 11-year-old patient, showing rhythmic midtemporal discharges during drowsiness.

Figure 32. EEG of a neonate of 35 weeks conceptional age, showing low-amplitude positive Rolandic sharp wave discharges at the vertex (CZ) electrode. Patient had grade IV intraventricular hemorrhage and was unresponsive.

Figure 33. EEG of a 5-day-old neonate, showing focal ictal pattern characterized by rhythmic sharp waves in the left Rolandic region.

Figure 34. EEG of a 5-day-old neonate on ventilator, showing "depressed brain seizure" characterized by less than one per second, low-amplitude sharp waves over the right hemisphere.

Figure 35. EEG of a 3-day-old comatose neonate with history of seizures, showing an electrographic "alpha band" seizure pattern without clinical accompaniment.

Figure 36. EEG of a 53-year-old man with one day history of acute confusion and slowness of motor responses, showing almost continuous generalized spike wave activity.

Figure 37. EEG of the same patient seen in Figure 36 following 4 mg of intravenous lorazepam, showing disappearance of all paroxysmal activity and mental clearing, highly suggestive of nonconvulsive status epilepticus.