Twenty years of ictal EEG-EMG

This study aimed to evaluate the use of ictal EEG recordings combined with simultaneous surface EMG in the diagnosis and analysis of motor events, bot h epileptic and nonepileptic. All ictal registrations were performed utiliz ing radiol cable telemetry. Routine recordings consisted of 18-channel EEG plus 8-channels bipolar surface EMG in freely moving patients. Combined ict al EEG-EMG recordings in freely moving patients enabled us to identify and define the following pathomechanisms of epileptic drop seizures, epileptic axial spasms, atonic, myoclonic-atonic, and akinetic seizures. Precise diff erentiation could be made between tonic and nontonic postural seizures and between startle-induced reflex seizures and hyperekplexia. The findings fro m telemetered ictal recordings in freely moving patients with combined EEG and surface EMG offer the only means of identifying, defining, and differen tiating motor events, both epileptic and nonepileptic, of a short duration that cannot be properly differentiated by clinical examination alone.