Pitfalls in ictal EEG interpretation Critical care and intracranial recordings

Neurology (Impact Factor: 8.29). 01/2013; 80(1 Suppl 1):S26-42. DOI: 10.1212/WNL.0b013e31827974f8


EEG is the cornerstone examination for seizure diagnosis, especially nonconvulsive seizures in the critically ill, but is still subject to many errors that can lead to a wrong diagnosis and unnecessary or inadequate treatment. Many of these pitfalls to EEG interpretation are avoidable. This article reviews common errors in EEG interpretation, focusing on ictal or potentially ictal recordings obtained in critically ill patients. Issues discussed include artifacts, nonepileptic events, equivocal EEG patterns seen in comatose patients, and quantitative EEG artifacts. This review also covers some difficulties encountered with intracranial EEG recordings in patients undergoing epilepsy surgery, including issues related to display resolution.

Download full-text


Available from: Nicolas Gaspard, Sep 29, 2015
174 Reads
  • Epilepsia 06/2013; 54(6):1135-6. DOI:10.1111/epi.12210 · 4.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sequence matching analyses show that Clostridium tetani neurotoxin shares numerous pentapeptides (68, including multiple occurrences) with 42 human proteins that, when altered, have been associated with epilepsy. Such a peptide sharing is higher than expected, nonstochastic, and involves tetanus toxin-derived epitopes that have been validated as immunopositive in the human host. Of note, an unexpected high level of peptide matching is found in mitogen-activated protein kinase 10 (MK10), a protein selectively expressed in hippocampal areas. On the whole, the data indicate a potential for cross-reactivity between the neurotoxin and specific epilepsy-associated proteins and may help evaluate the potential risk for epilepsy following immune responses induced by tetanus infection. Moreover, this study may contribute to clarifying the etiopathogenesis of the different types of epilepsy.
    06/2014; 2014:236309. DOI:10.1155/2014/236309