An EEG recording showing high-voltage spikes followed by slow waves may indicate which condition?

High-voltage spikes followed by slow waves in an EEG recording are characteristic findings often associated with temporal lobe epilepsy. This type of epilepsy typically presents with interictal spikes, which are high-voltage and occur due to increased excitability of the neurons in the temporal lobe. Following these spikes, the slow waves represent the subsequent inhibitory processes as the brain attempts to restore a state of balance after the excitation.

Temporal lobe epilepsy may manifest as focal seizures, which can involve complex behaviors such as alterations in consciousness, sensory experiences, and motor functions, all of which can correlate with the abnormalities found on an EEG. This specific pattern of spikes and slow waves provides insight into the epileptogenic focus within the temporal lobe, making it a critical finding for diagnosing this condition.

In contrast, conditions like psychogenic non-epileptic seizures and episodic syncope typically do not show this specific EEG pattern, as they may present with different features or remain entirely normal during episodes. Subcortical infarction may lead to various EEG changes, but the pattern of high-voltage spikes followed by slow waves is not a hallmark of this condition. Therefore, the EEG finding described aligns most closely with temporal lobe epilepsy.