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Transient ischaemic attack — SCE Neurology MCQ

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HardStrokeTransient ischaemic attackSCE Neurology

A 70-year-old is awake and follows commands after treatment of a convulsive seizure. Continuous EEG shows reactive generalised periodic discharges at 1.5 Hz lasting minutes, without spatiotemporal evolution or a clinical correlate. Which EEG classification is most accurate?

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Correct answer: A — An ictal-interictal continuum EEG pattern

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

A is correct: reactive 1–2.5 Hz periodic or rhythmic discharges lasting at least 10 seconds but lacking evolution or clinical correlate fall on the ictal-interictal continuum. They carry seizure risk and require clinical-contextual management, but do not automatically satisfy electrographic criteria for non-convulsive status. The patient is not convulsing. Wicket waves are benign temporal variants and do not resemble sustained generalised periodic discharges. The distinction prevents both dismissal of a potentially harmful pattern and reflexive over-treatment as definite status.

Reference: Electroencephalography in encephalopathy and encephalitis: https://pn.bmj.com/content/24/1/2