image: eeg0087


EEG Report or Clinical history: CLINICAL HISTORY:
This is a 9 year old girl with a history of absence epilepsy. Manifestations include eyes movements and staring. Seizures were well controlled with ethosuximide but she was weaned about 1.5 months ago and she is having recurrent events. Routine EEG 4/2/2012 while on ethosuximide was normal. Repeat EEG is requested to characterize baseline frequency of epileptiform activity off all medications. She is sleep deprived.

The awake background included a 9 Hz posterior dominant rhythm that attenuated with eye opening. During the awake portion there were three short bursts of well formed 3 Hz generalized, bifrontally predominant spike and wave activity, each lasting about 2 seconds and all occurring during hyperventilation. They were not seen during photic stimulation. During drowsiness, identified by ocular signs and alpha attenuation, there was 2-4 Hz, frontotemporal polymorphic delta activity. Stage II sleep was identified by vertex waves, sleep spindles and K complexes. Some small polyspikes were observed superimposed with one K complex but otherwise there was no epileptiform activity during sleep. There were no lateralizing abnormalities.

This EEG is abnormal due to 4-5 Hz spike and wave activity. The described generalized spike and wave activity is consistent with a diagnosis of idiopathic generalized epilepsy. However, focal onset epilepsy with rapid secondary bisynchrony cannot be absolutely excluded.

tags: idiopathic generalized epilepsy