| خلاصه مقاله | EEG recording, the use of anterior temporal electrodes (T1, T2) or invasive sphenoidal electrodes can increase the sensitivity for the detection of mesial temporal epileptiform discharges .Up to two thirds of standard recordings show no epileptiform activity (only focal slowing or no abnormalities). When present, the epileptiform discharges can be unilateral or bilateral (The interictal epileptiform activity is typically bilateral, even in patients with unilateral seizures, but typically one side has a preponderance). Sleep deprivation can often activate focal epileptiform discharges; therefore, an EEG with sleep recording is recommended during the diagnostic workup. The presence of mid or posterior temporal spikes may suggest a more widespread epileptogenic network even in the presence of clear mesial temporal pathology. The ictal EEG is typically characterized by rhythmic alpha or theta activity that evolves into higher-amplitude rhythmic delta or theta activity that may be sharply contoured or contain discrete spikes . Often, the initial ictal discharge may be preceded by an initial sharp wave or suppression of the normal EEG patterns or epileptiform activity that was occurring immediately before the ictus. Other patterns at onset include rhythmic delta with or without spikes .
The typical EEG ictal onset are a 5-9 Hz rhythmic activity at the temporal electrodes or a focal suppression of background activity associated with low-voltage fast rhythms followed by a 5-9 Hz activity .
Alternatively, more or less rhythmic sharp waves can be seen at ictal onset . Another study suggested that a regular recruiting 5-9 Hz persisting for longer than 5 s over the temporal electrodes was associated with mesial temporal seizure onset. On the other hand, lateral neocortical onset was characterized either by 2-5 Hz rhythms of lesser stability, possibly evolving towards 5-9 Hz activity or by absent/diffuse modifications of the EEG background.
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