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Chapter 21: Neurocognitive Disorders
Figure 21.5-1
Electroencephalographic recording during general-
ized tonic-clonic seizure showing rhythmic sharp
waves and muscles artifact during tonic phase, spike
and wave discharges during clonic phase, and atten-
uation of activity during postictal state. (Courtesy of
Barbara F. Westmoreland, M.D.)
loses contact with the environment, are characteristic of petit mal epi-
lepsy, but the patient has no true loss of consciousness and no convulsive
movements during the episodes. The EEG produces a characteristic pat-
tern of three-per-second spike-and-wave activity (Fig. 21.5-2). In rare
instances, petit mal epilepsy begins in adulthood. Adult-onset petit mal
epilepsy can be characterized by sudden, recurrent psychotic episodes
or deliriums that appear and disappear abruptly. The symptoms may be
accompanied by a history of falling or fainting spells.
Figure 21.5-2
Petit mal epilepsy characterized by
bilaterally synchronous, 3-Hz spike
and slow-wave activity.
partial
seizures
.
Partial seizures are classified as either sim-
ple (without alterations in consciousness) or complex (with an
alteration in consciousness). Somewhat more than half of all
patients with partial seizures have complex partial seizures.
Other terms used for complex partial seizures are temporal
lobe epilepsy, psychomotor seizures, and limbic epilepsy; these
terms, however, are not accurate descriptions of the clinical
