Version June 2024
| Epilepsy syndromes | EEG findings | Additional EEG features |
| Generalized | ||
| Absence epilepsy | 3-Hz generalized spike-and-slow wave; often repetitive trains of discharges | Normal background; activation of IEDs and seizures with hyperventilation |
| Atypical absence epilepsy | 1.5 to 2.5-Hz generalized spike-and-slow wave discharges | IEDs may be asymmetric, with shifting focal features |
| Juvenile myoclonic epilepsy | 4 to 6-Hz generalized spike and multiple spike-and-slow wave | Normal background; activation of IEDs with photic stimulation is common; more typical 2.5 to 3-Hz spike-and-slow wave may be seen; IEDs may be asymmetric, with shifting focal features |
| Infantile epileptic spasms syndrome | Hypsarhythmia and multifocal spikes and sharp waves | No clearly normal background activity since the EEG is dominated by the hypsarhythmia pattern |
| Lennox-Gastaut syndrome | <2.5-Hz generalized sharp-and-slow wave discharges | Generalized background slowing and paroxysmal fast activity; often multifocal spikes and sharp waves |
| Progressive myoclonic epilepsy | Generalized and multifocal spikes, multiple spikes, and sharp waves | Progressive background slowing with disease progression; photic activation of IEDs in some cases |
| Focal | ||
| Self-limited epilepsy with centrotemporal spikes (SeLECTS) (Previously called benign rolandic epilepsy) | Large-amplitude spikes or sharp waves, maximal over the centrotemporal region | Normal background; often prominent activation of IEDs with sleep; the discharge can be bilateral or unilateral and often has an anterior-posterior field of a tangential dipole |
| Childhood occipital visual epilepsy (Previously called benign occipital epilepsy) | Bilateral or unilateral occipital spike-and-slow wave discharges | Occipital IEDs often attenuate with eye opening; photic stimulation may precipitate seizures |
| Temporal lobe epilepsy | Temporal lobe spikes, sharp waves, and temporal intermittent rhythmic delta activity; often activated with drowsiness and sleep | Often intermittent or persistent temporal slowing; may see independent IEDs from contralateral temporal lobe |
| Frontal lobe epilepsy | IEDs in the frontal region | Mesial frontal discharges often are not detected by scalp EEG; secondary bilateral synchrony can occur |
Adapted with permission from: Worrell GA, Lagerlund TD, Buchhalter JR. Role and limitations of routine and ambulatory scalp electroencephalography in diagnosing and managing seizures. Mayo Clin Proc 2002; 77:991. Copyright © 2002 Dowden Health Media.
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