Many of the clients we work with at our clinic encounter difficulties related to maintaining attention on a task, with quality and for satisfactory periods of time. Neurofeedback interventions with these individuals have a high success rate, especially in cases where attention difficulties are associated with the excessive presence of low-frequency rhythms (or, if you prefer, "slow activity") in the client's electroencephalogram. These low-frequency rhythms can be present constantly and continuously, or they can appear for short seconds, with varying intensity.
In most cases of Attention Deficit diagnosis, we observe an excessive and relatively constant presence of slow rhythms, as exemplified by the brain map shown in Figure 1 below, compared to a Normal Brain Pattern:
However, in many cases, we encounter sporadic slow activity present for brief seconds. Due to this brevity, it is less noticeable on the brain maps resulting from the electroencephalogram. In fact, these individuals may have a brain map very close to the ideal in the lower frequency bands but still have serious difficulties maintaining attention due to these sporadic "peaks" of slow activity.
Figure 2 shows on the left the trace of an electroencephalogram with a normal brain pattern and on the right the trace of an electroencephalogram where this type of activity is evident, marked by the red rectangle:
It is visible, by comparison with the rest of the EEG trace, that the areas marked by the red rectangle have a different morphology, with a greater amplitude, more "rounded," and with a lower frequency. These periods correspond to the mentioned "peaks" of slow activity, which are strongly related to periods when the person's attention deviates from the task at hand, loses focus, and resumes after a few seconds.
This description corresponds to common distraction. During these moments, the person is easily "called back" to the task at hand and does not exhibit other symptoms beyond the mentioned loss of focus.
On the other hand, absence seizures are manifestations of certain epilepsy conditions. Their manifestation presents symptoms very similar to simple and common distraction, and for this reason, they are often undervalued without immediate diagnosis.
Absence seizures are more common in children between the ages of 4 and 14 and are often misinterpreted as inattention and distraction. They are frequently associated with learning difficulties.
Figure 3 shows the changes in the EEG during an absence seizure compared to a normal situation. It is possible to see a generalized slowing of the trace, with greater amplitude in the bilateral frontal region, always associated and interspersed with more abrupt activity with a spike-like shape, characteristic of this type of epilepsy:
During an absence seizure, which can last between 10 to 20 seconds, we can see the child abruptly stop the activity they are doing, have a blank/fixed stare, and sometimes exhibit some muscle or motor changes, such as constant blinking at an abnormally rapid rate, lip smacking, chewing movements, and/or hand movements.
Within this brief period when the child is having a seizure, they do not respond to any auditory, visual, or tactile stimuli, and when the seizure ends, the child can resume the activity as if nothing happened or may experience a brief period of confusion, always with no memory of the event.
Therefore, when there is a suspicion of epilepsy, it is necessary for those around the child, such as parents, family members, caregivers, and teachers/educators, to be attentive and know how to interpret and recognize the differences between normal distraction and an absence seizure, so that the correct diagnosis and intervention can be made as quickly as possible.
In summary, the main differences are as follows:
Common Distraction:
Absence Seizure:
