Which EEG finding is most likely during a psychogenic nonepileptic seizure?

During a psychogenic nonepileptic seizure (PNES), the EEG findings typically demonstrate a normal awake background rhythm. This characteristic is significant because it helps distinguish PNES from true epileptic seizures, which usually present with definite epileptiform activity or abnormal rhythms on the EEG.

The presence of a normal awake rhythm indicates that there is no underlying epileptic activity occurring in the brain during these episodes. This can be crucial in diagnosis, as clinicians rely on the EEG to differentiate between seizures that arise from neurological conditions versus those that may be psychological in origin.

While abnormal rhythmic spikes or high amplitude bursts may indicate the presence of epileptic activity, these are not characteristics associated with PNES. Additionally, flat electrocorticographic activity (which reflects a lack of cerebral electrical activity) is typically seen in severe conditions, such as coma, rather than in PNES. Thus, the identification of a normal awake rhythm in the context of a suspected psychogenic seizure is aligned with the expected EEG findings for that condition.