Abstract
Electroencephalographers may misclassify benign variant EEG patterns as epileptiform discharges, resulting in delays in the diagnosis and appropriate treatment of other paroxysmal disorders, such as psychogenic nonepileptic seizures, anxiety/panic disorders, and near syncope. These benign variant patterns include wicket spikes, small sharp spikes, and rhythmic mid-temporal theta of drowsiness. Cautious interpretations of semi-rhythmic sharp transients, usually gradually rising from the EEG background in drowsiness, can help avoid misdiagnosing patients as having seizures. Viewing the EEG as confirmatory for a clear clinical diagnosis is also helpful - elderly patients with syncope, for example, often have microvascular disease and EEG wicket rhythms in drowsiness - a careful review of the clinical history and the paroxysmal EEG pattern usually help distinguish normal variant patterns from interictal sharp waves and spikes and avoid misdiagnosing epilepsy.
Original language | English (US) |
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Pages (from-to) | 257-263 |
Number of pages | 7 |
Journal | Journal of Clinical Neurophysiology |
Volume | 36 |
Issue number | 4 |
DOIs | |
State | Published - Jul 1 2019 |
Keywords
- Benign or normal variant EEG patterns
- Epilepsy misdiagnosis
- Interictal epileptiform discharges
- Rhythmic mid-temporal theta of drowsiness
- Small sharp spikes
- Wickets rhythms/spikes
ASJC Scopus subject areas
- Physiology
- Neurology
- Clinical Neurology
- Physiology (medical)