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Kellaway P. The electroencephalographic features of benign centrotemporal (rolandic) epilepsy of childhood. . 2000 Aug. 41(8):1053-6. .

Reeves AL, Klass DW. Frequency asymmetry of sleep spindles associated with focal pathology. . 1998 Jan. 106(1):84-6. .

San-Juan OD, Chiappa KH, Costello DJ, Cole AJ. Periodic epileptiform discharges in hypoxic encephalopathy: BiPLEDs and GPEDs as a poor prognosis for survival. . 2009 Jun. 18(5):365-8. .

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Terzano MG, Parrino L, Mazzucchi A, Moretti G. Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly. . 1986 Jul-Aug. 27(4):446-57. .

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Worrell GA, Lagerlund TD, Buchhalter JR. Role and limitations of routine and ambulatory scalp electroencephalography in diagnosing and managing seizures. . 2002 Sep. 77(9):991-8. .

Media Gallery
Abnormal asymmetric photic driving in a 4-year-old boy with seizures. While lesser degrees of amplitude asymmetry in photic driving are not reliable indicators of pathology, in this case the amplitude difference is at least 5-fold. The photic driving response is usually attenuated on the abnormal side. Here, the preponderance of the slowing over the right posterior head regions with the eyes open, along with the probable spikes in the same area, suggest that the affected side may be the right. In addition, the abnormality occurs in the presence of scanning eye movements (note the horizontal eye movements just before, during, and after photic stimulation), which would often attenuate the driving response.
Patient is a 4-year-old boy with seizures. Photic stimulation at a higher frequency provokes spikes with a widespread field with the principal phase-reversal at 02.
Asymmetric sleep spindles. This EEG is from a 12-year-old boy with seizures. The frontally displaced 12-Hz sleep spindles are attenuated on the right. Frontally displaced spindles are a normal variant. They are often slightly slower than, and coexist with, centrally predominant spindles. However, the asymmetry of the spindles is an abnormality and could be a consequence of a structural lesion on the right.
Continuous polymorphic delta. This EEG is from a 23-year-old woman who suffered a right middle cerebral artery stroke. She had a history of rheumatic fever and mitral valve replacement. There is continuous polymorphic delta slowing over the left temporal lobe. Faster activities are attenuated in the same region. Note the irregularly irregular heart rate, consistent with atrial fibrillation.
Frontally predominant intermittent rhythmic delta activity (FIRDA) in a 53-year-old woman with a metabolic encephalopathy.
Triphasic waves in a 61-year-old man with uremia. Each of the 3 phases of these frontally predominant waves is longer in duration than the preceding phase. The second phase is positive in polarity and has the greatest amplitude. There is a suggestion of the anterior to posterior phase delay that is often associated with triphasic waves. While this very rarely represents an ictal pattern, the possibility of seizures would have to be entertained if the clinical scenario was strongly suggestive, that is, if a similar pattern was recorded from a metabolically intact adolescent with waxing and waning confusion.
Rhythmic mid temporal theta bursts of drowsiness (RMTD). The EEG was recorded from a drowsy 9-year-old boy with seizures. These monomorphic waves occur bilaterally but with greater amplitude on the right. RMTD might be mistaken for pathological intermittent rhythmic slowing or an ictal pattern. Unlike an ictal pattern, these discharges do not evolve in frequency or distribution.
Left anterior temporal spike. This EEG was recorded in the drowsy state (note the absence of a posterior dominant rhythm and the presence of slow horizontal roving eye movements). The patient was a 53-year-old man with a history of monthly episodes of behavioral arrest and automatic behavior consistent with complex partial seizures arising from the temporal lobe.
Right posterior temporal spike. This EEG is from a 15-year-old boy with a history of complex partial seizures. The spike phase reverses at T6. The field of the discharge extends into the parietal and occipital regions.
An EEG typical of the syndrome of benign childhood epilepsy with centrotemporal spikes (BECTS). This EEG was recorded from an otherwise neurologically normal 9-year-old boy with nocturnal seizures that consisted of drooling and clonic contractions of 1 side of the face and arm. There are frequent right-sided central mid temporal spikes. These stereotyped discharges exhibit a positive phase-reversal over the frontal region (asterisks). A longitudinally oriented horizontal dipole is frequently seen in patients with BECTS, although it is not specific for this syndrome.
Pseudoperiodic lateralized epileptiform discharges (PLEDS) in a 45-year-old woman after a stroke. These sharply contoured waveforms phase-reverse over the right posterior temporal region. Their fields involve much of the right hemisphere.
PLEDs in an elderly patient with an acute right middle cerebral artery infarction. These 0.5- to 1-Hz discharges with superimposed sharply contoured beta activities are more ictal-appearing than those seen in the previous example. Is this a seizure? See next image.
PLEDs in an elderly patient with an acute right middle cerebral artery infarction. In the sixth second the interictal PLEDs are replaced by a clearcut evolving seizure pattern.
Ictal PLEDs. This patient underwent an elective left-sided evacuation of a subdural hematoma some months before this EEG was recorded. This study was done to evaluate right-sided myoclonic jerks and aphasia in the setting of a urinary tract infection. The myoclonic jerks were time-locked to the left-sided PLEDs in previous image. These discharges, the myoclonic jerks, and the aphasia all resolved after treatment with antibiotics and valproate. Because these discharges were associated with a reversible neurologic deficit and time-locked to a focal movement, they were classified as an ictal pattern.
Pseudoperiodic generalized epileptiform discharges (GPEDs) in a 67-year-old patient after cardiac arrest. Some authors would refer to these discharges as bilateral pseudoperiodic epileptiform discharges (BiPEDs).
These GPEDS were recorded in a 17-year-old with subacute sclerosing panencephalitis (SSPE). The patient presented with a slowly progressive encephalopathy and myoclonic jerks when awake. When GPEDs are present in SSPE, they typically repeat at a relatively low frequency and have a complex morphology. During a single recording, the morphology and repetition rate of the discharges are often strikingly stereotyped. When myoclonic jerks are present, they are time-locked to the periodic discharges.
Posterior slow waves of youth punctuate the posterior rhythm in this normal EEG recorded from a 9-year-old girl. They might be mistaken for occipital spikes or slow waves. Posterior slow waves of youth invariably share the same distribution and reactivity as the alpha rhythm. Persistence of the transient with eye opening or into drowsiness, when the alpha rhythm attenuates, would suggest an abnormality.
Positive occipital sharp transients of sleep (POSTS) are present in this normal EEG, recorded from a 13-year-old girl in sleep. These bisynchronous discharges occur in brief runs at 4-5 Hz. POSTS also occur unilaterally and as isolated discharges. They first occur in stage 1 sleep and may persist into slow wave sleep.
A burst-suppression pattern, a species of GPEDs, recorded after prolonged cardiac arrest. Mixed frequency, low-amplitude bursts of variable morphology are separated by periods of profound background attenuation.
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Contributor Information and Disclosures
Author

Alexis D Boro, MD Assistant Professor, The Saul R Korey Department of Neurology, Albert Einstein College of Medicine; Physician, Department of Neurology, Montefiore Medical Center Alexis D Boro, MD is a member of the following medical societies: D Knight Platform Shoes Women Spring Autumn Designer Free Shipping Limited Edition H1XsNaY
, American Epilepsy Society Disclosure: Nothing to disclose.

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» Attention

Overview

The Attention module provides the ability to play pre-defined sounds, methods for managing vibration, and control of the back light.

Not all devices fully support this module, so checks are recommended. For example, the vivoactive does not have a tone generator and will trigger an error if an app attempts to play sounds.

Since:

1.0.0

App Types:

Data Field

Widget

Classes: VibeProfile

Classes:

Indicates that a key was pressed

1.0.0

Supported Devices:

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that an activity has started

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that an activity has stopped

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that a message is available

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

An alert ending with a high note

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

An alert ending with a low note

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

A loud beep

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates a change in interval

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates an alarm has triggered

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that the activity was reset

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that the user has completed a lap

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

An annoying sound to get the users attention

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

An alert that a time threshold has been met

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

An alert that a distance threshold has been met

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that the activity was a failure

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that the activity was a success

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

The power on tone

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates that the device has low battery power

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

Indicates an error occurred

1.0.0

All devices except Approach S60 / vivoactive / vivoactive HR / Edge 130

backlight

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