@vumcpedepilepsy GPFA (12-14 Hz generalized paroxysmal fast activity) in sleep. It has been described in Lennox Gastaut syndrome, as well as in other generalized epilepsies. Polygraphy using deltoid, trapezius surface EMG electrodes, might sometimes correlate this with subtle tonic seizures
@vumcpedepilepsy Near continuous generalized, frontally dominant slow (2 Hz) SW discharges, with persistent higher amplitude L, clinically manifesting as atypical absences (correct usage is "prolonged focal unaware seizures" and NCSE). Maybe worthwhile working up for resective epilepsy surgery
@vumcpedepilepsy Lambda waves , normal physiological waves. These are bilateral occipital, triangular shaped waveforms, with positive polarity, seen during visually scanning a picture or watching a video
@vumcpedepilepsy Early myoclonic encephalopathy is likely, (if there's no h/o asphyxia or HIE), indicates poor neurol prognosis. Differentials of EME are broad, including metabolic(NKH, pyridoxine dependency etc) & genetic (SCN, CDKL5, GABR). Accurate diagnosis guides Rx and prognosis