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R.EEGT - Photic stimulation response, Cheat Sheet of Neuroscience

A part of Essential Concepts for the R.EEG.T Exam – Includes Tables, Diagrams, and Illustrations. Table of contents: 44 pages - Filters, time constant. common mode rejection and digital EEG setting parameters - Montages - Normal varients - Artifacts - Increasing beta/fast activities - N2 sleep and Arousal pattern - Pediatric EEG and syndrome by age group - Neonatal sleep wake pattern - Pediatric epilepsy syndrome by interictal pattern - Differential of sleep provoked seizure - Photic stimulation - Hyperventilation - Lateralization - Severity of encephalopathy and EEG pattern - Rhythmic delta - Clinical seizure correlate with EEG - Seizure semiology

Typology: Cheat Sheet

2024/2025

Uploaded on 05/11/2025

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Photosensitive epilepsy
-Jeavons Syndrome (JS) – rare genetic occipital epilepsy found PPR up to 90% - seizures that are often triggered by
eye closure, characterized by eyelid myoclonia, upward jerking of the eyelids, and may present with absence
behavior.
Response/Artifact Source EEG Appearance Localization Clinical Relevance
Photic Driving Cortical:
physiologic
Temporal relationship w
stimulus frequency:
Harmonic – 2x of flash strobe/
, Subharmonic- ½ of fs
-Stop when flash stop
Occipital -Most drive at alpha 8-13 Hz
- No photic driving can be normal esp. in
older > 50, drowsy
- Asymmetrical responses are likely
abnormal but need to consider
asymmetrical light exposure.
-Absent on one side is abnormal
(Banquad)
Photoparoxysmal
(PPR)
Cortical
: Epileptic
-Spikes, polyspikes, spike-wave
-no temporal relation to
flashing
-May persist after flash stop
Occipital,
parietal, frontal,
generalized
(waltz I, II, III, IV)
Photosensitive epilepsy (mostly genetic) *
Barbiturate/Alcohol withdrawal
most in 10 s of 15-25 Hz flashing strobe
Stop flashing if a clinical seizure
Photomyogenic
(PMR)/Photomyoclonic
and
Electroretinogram
(ERG)
Frontalis muscle
Retinal
High-frequency spikes
Low-amplitude waves
Frontal Involuntary frontal muscle response
Normal retinal response
Photoelectric Artifact Electrodes that
have poor
impedance
Rhythmic signal at IPS
frequency
Single channel Test by covering the suspected
electrode/fixing the electrode
pf3

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Photosensitive epilepsy

  • Jeavons Syndrome (JS) – rare genetic occipital epilepsy found PPR up to 90% - seizures that are often triggered by eye closure, characterized by eyelid myoclonia , upward jerking of the eyelids, and may present with absence behavior. Response/Artifact Source EEG Appearance Localization Clinical Relevance Photic Driving Cortical: physiologic Temporal relationship w stimulus frequency: Harmonic – 2x of flash strobe/ , Subharmonic- ½ of fs -Stop when flash stop Occipital -Most drive at alpha 8-13 Hz
  • No photic driving can be normal esp. in older > 50, drowsy
  • Asymmetrical responses are likely abnormal but need to consider asymmetrical light exposure. -Absent on one side is abnormal (Banquad) Photoparoxysmal (PPR) Cortical : Epileptic -Spikes, polyspikes, spike-wave -no temporal relation to flashing -May persist after flash stop Occipital, parietal, frontal, generalized (waltz I, II, III, IV) Photosensitive epilepsy (mostly genetic) * Barbiturate/Alcohol withdrawal most in 10 s of 15-25 Hz flashing strobe Stop flashing if a clinical seizure Photomyogenic (PMR) /Photomyoclonic and Electroretinogram (ERG) Frontalis muscle Retinal High-frequency spikes Low-amplitude waves Frontal Involuntary frontal muscle response Normal retinal response Photoelectric Artifact Electrodes that have poor impedance Rhythmic signal at IPS frequency Single channel Test by covering the suspected electrode/fixing the electrode
  • Juvenile Myoclonic Epilepsy (JME) – the most common genetic generalized epilepsy found in 30% - of onset teenagers, triggered by sleep deprivation, stress, and periods (like migraine triggers), commonly occurs in the transition from sleep to wake, with upper limb jerking follow by GTCs
  • Sunflower syndrome (SFS) is a rare childhood epilepsy with sensitivity to light and a tendency to move towards bright

sources. Usually antiepileptic drug-resistant – need avoid light exposure

  • Occipital hyperexcited inborn error metabolism ie Batten disease - characteristic photic spike appears in very freq 1-3 Hz