Stimulus state, evolution, fluctuation, and static modifiers

Criteria & assessment

stimulus state

SI

Reproducibly brought about or exacerbated by alerting stimulus in a less-stimulated state, with or without clinical alerting; may also occur spontaneously.

ST

Reproducibly terminated or attenuated by alerting stimulus in a less-stimulated state, with or without clinical alerting; may also self-terminate.

spontaneous

Never clearly induced, exacerbated, improved, or terminated by stimulation.

unknown

Unclear or untested.

stimulus type required

• auditory
• light tactile
• patient care/other nonnoxious
• noxious

evolving

minimum

At least 2 unequivocal sequential changes in the same category.

frequency

Two consecutive changes in one direction, each at least 0.5 Hz; each frequency persists at least 3 cycles.

morphology

Two consecutive novel morphologies; each morphology, including transition forms, persists at least 3 cycles.

location

Sequential spread into or out of at least 2 standard 10-20 electrode locations; involvement of each additional electrode persists at least 3 cycles.

interstep gap

Reach criteria without the changing feature remaining unchanged for 5 or more continuous minutes.

amplitude

Voltage/amplitude change alone is neither evolution nor a new morphology.

fluctuating

minimum

At least 3 changes, no more than 1 minute apart, not qualifying as evolution.

frequency

Each change at least 0.5 Hz; each frequency persists at least 3 cycles.

morphology

Each morphology persists at least 3 cycles.

location

Each change at least 1 standard interelectrode distance; each location persists at least 3 cycles.

amplitude

Voltage/amplitude change alone is not fluctuation.

static

Neither evolving nor fluctuating.

additional reporting

If evolving or fluctuating in frequency, specify minimum and maximum frequency. For nongeneralized patterns specify spread as none, unilateral, or bilateral.