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INDICATIONS:  This study is done to evaluate for possible seizures.

This is a multichannel digital EEG recording using the international 10-20 placement system.  The resting record is poorly organized but symmetric.  A dominant posterior rhythm is seen but is poorly sustained.  When present, it consists of a 10 hertz, 20 to 50 microvolt alpha rhythm.  This attenuates with eye opening.  During drowsiness, there is mild attenuation and slowing of the background rhythm.  Stage II sleep was not achieved.  Hyperventilation was not performed.  Photic stimulation did not significantly alter the background rhythm.  Prominent muscle artifact and movement artifact as well as electrode artifact was noted during this recording.  There was noted also a single sharp left temporoparietal discharge.

IMPRESSION:  This is a probably normal awake and drowsy EEG recording.  The presence of a single sharp discharge could be normal finding.  However, in the appropriate clinical setting, it may be also consistent with a seizure disorder with focal onset.  If indicated, repeat EEG and/or 24-hour ambulatory EEG monitoring might be useful in the future.



INDICATIONS:  This is an outpatient, right-handed female who had a syncopal episode.

Routine 18-channel digital EEG was obtained to rule out any seizure activity.

FINDINGS:  Background rhythm during awake stage shows well-organized and well-developed average voltage 9-10 hertz alpha activity predominantly in the posterior regions.  This blocks with eye opening and is bilaterally synchronous and symmetrical.  No spike-and-wave discharges or any lateralizing abnormalities are seen.  Photic stimulation did not produce any abnormalities.  Stage II sleep is not observed.  A brief drowsiness was seen in the later part of the recording.  Hyperventilation was also performed for 3 minutes, no abnormalities were seen during the procedure.

IMPRESSION:  Normal study.  No epileptiform discharges or any other paroxysmal activities or focal abnormalities are seen.  Clinical correlation recommended.



INDICATIONS:  A patient with unexplained encephalopathy and possible seizure.

TECHNIQUE:  This was a relatively good quality portable EEG recording obtained in the intensive care unit.

FINDINGS:  Early in the recording, EEG pattern consisted of alternating periods of low to medium amplitude fast activity in alpha and beta frequencies of diffuse distribution interrupted by periods of high amplitude generalized 1-1/2 to 3 cycle per second delta activity.  Very occasionally, generalized spike-like discharges or sharp waves were seen.  Sometimes, these would occur apparently at the beginning of a period of generalized delta activity.  As the recording progressed, the activity described above began to be supplanted by low to medium amplitude diffuse beta activity often intermixed with vertex-like waves of sleep.  Thus, as the recording proceeded, patterns resembling sleep or even sedated sleep became more apparent.  In addition, intermixed periods of wakefulness with considerable muscle artifact and irregular intermixed delta, theta, and alpha activity were seen without a clear-cut, well-regulated alpha rhythm. Hyperventilation and photic stimulation not performed.

IMPRESSION:  Abnormal EEG characterized by periods of high amplitude generalized slowing consistent with an encephalopathy.  These are interrupted by periods of prominent beta activity suggesting sedated sleep.  There were no definite epileptiform discharges; although, as mentioned, early in the recording, some isolated spikes that seemed to be generalized may have been present.  The findings are of course consistent with a global encephalopathy, but are otherwise nonspecific.  There were no definite epileptiform patterns. 



INDICATIONS:  A patient referred for the evaluation of possible seizures.

TECHNIQUE:  A technically satisfactory 18-channel digital recording.

FINDINGS:  Towards the end of the recording, a brief period of wakefulness was seen.  During this time, some fairly regular, medium amplitude, fairly well formed, 8 to 9 hertz alpha rhythms were seen occipitally. Hyperventilation was not performed. Intermittent photic stimulation failed to elicit any definite abnormalities, although some runs of sharply contoured frontal delta were seen during intermittent photic stimulation as well as at other times during the recording. Most of the recording consisted of sleep.  Vertex sharp transients, K-complexes, and sleep spindles were observed. Several suspicious features were seen during the recording.  In particular, relatively frequent, brief intermittent runs or trains of quasi-periodic, sharply contoured, frontally dominant, 2 to 3 hertz delta activity were seen.  These were primarily right frontal in maximal amplitude, although rarely some left frontal runs were also observed.  These typically lasted 2 to 4 seconds or sometimes slightly more.  In addition, rare bursts of irregular, high amplitude, spike and wave-like or sharp and slow wave-like discharges were seen. .

IMPRESSION:  Probably abnormal awake and sleep EEG for age due to brief runs of right frontal, sharply contoured delta activity.  Sometimes, these frontal delta waves were maximal over the left frontal region, but more commonly over the right.  Finally, occasional, irregular generalized spike-and-wave discharges or sharp and slow wave-like discharges were seen.  The EEG was difficult to interpret, but these features are considered to be probably abnormal.  They could be consistent with a clinical seizure disorder.

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