Notice how, on the example below, all the tracings have essentially the same movement-this is much too organized for something like slow wave sleep, and while ictal patterns can certainly lead to such rhythmicity, there is no evidence on this single page of the evolution across time or location that characterize seizures. It arises from the movement of the tongue, and appears as slower, diffuse delta frequency activity. Hypoglossal artifact is often but not requisitely seen with chewing artifact. Just be careful not to mix it up with generalized periodic fast activity, which tends to be slightly slower (beta frequency) and lower in amplitude. It is quite easy to characterize with video studies, as you can just look at the video to correlate, but even without video studies chewing artifact does not usually share a close morphology with any other important physiologic activity. Chewing artifact is really just muscle artifact from the temporalis muscle, and is marked by sudden onset, intermittent bursts of generalized very fast activity (muscle artifact). Chewing and tongue (hypoglossal) artifact are rather hard to miss on EEG.
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