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Interictal or ictal discharges are the basis of EEG interpretation when seizure localization is the goal, but a new report suggests an alternative. It has been known for over 40 years that, when DC recordings are made, seizures may be associated with localized, very slow, sustained voltage changes, which do not oscillate (ictal DC shift).1 These voltage changes occur more or less simultaneously with the rhythmic oscillating (AC) voltages that are the conventional EEG correlate of seizures. In this issue of Neurology, Vanhatalo et al.2 report prolonged DC-EEG recordings from five patients with temporal lobe epilepsy who were monitored for seizure localization by video/EEG. They conclude that DC-EEG recordings at the bedside are practical and that ictal DC shifts are consistently observed in scalp recordings and reliably lateralize temporal lobe seizures.
The major impediment to …
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