Electrodes were placed using the routine 10=20 electrode placement system with additional use of T1 and T2 electrodes to further categorize anterior temporal lobe activity.

Baseline EEG
During maximally awake state, a posterior dominant rhythm of 8-9 cycles per second was seen whic was well sustained and regulated, symmetrical and reactive to eye opening. Anterior background was characterized by medium amplitude frequencies in the alpha range with occasional intermixed theta activity. Very frequent medium to high amplitude spike-slow wave discharges were seen in the right centrotemporal head region (C4, T4) which had a wide field of distribution spreading to involve the right anterior temporal (F8) head regions as well at times.

Sleep
Stage 11 sleep was characterized by symmetric vertex sharp transients and sleep spindles. The above-mentioned epileptiform discharges were significantly activated by sleep becoming higher in amplitude and occuring more frequently.

Hyperventilation performed for three minutes with good effort and no additional abnormalities seen.
Photic stimulation performed at various flash frequencies and no additional abnormalities detected.

Prolonged video eeg Monitoring;
During the remainder of the day. The patient was monitored during wakefulness and sleep. During wakefulness, the background remained unchanged from that described in the baseline EEG continuing to be normal.
Very frequent medium to high amplitude spike-slow wave discharges was seen in the right centrotemporal (C4, T4) head regions with a wide field of distribution spreading to involve the right anterior temporal (F8) head regions as well, as described in the baseline EEG.

During the course of this two-day study, the patient did not experience any of the habitual events for which he had been referred. In addition, no electrographic seizures were recorded.

Sleep
Stage 11 sleep was characterized by symmetric vertex sharp transients and sleep spindles. Normal sleep architecture was seen during all the recorded stages of sleep. During sleep, the above- mentioned epileptiform discharges were significantly activated occuring more frequently and being higher in amplitude.

On a few occasions, the right centrotemporal epileptiform discharges did apppear to occur repetitively in paroxysms lasting for 1 to 2 seconds but did not show any evolution. They were not associated with any clinical seizure-like activity at this time.

Impressions
During this study, the baseline EEG was abnormal because of the presence of an active focus of epileptiform activity in the centrotemporal head region (C4, T4) with a wide field of distributions spreading to involve the ipsilateral anterior temporal head region (F8) as well. These findings place this patient at risk for focal and secondarily generalized seizures.



Anyone that can help me with this. It would be appreciated.

I was told this one is just like the rest. But its not really. Or if it is then its not been so complete before. Its got terms I've never heard of. And I'm really been given some things I've never seen before

like what is ipsilateral anterior temporal head region.

I don't think this is a misprint.

Donna

The abnormalities are seen in the frontal lobe (F8), Temporal, (T4) CentroTemporal (C4) ......Sounds like it shows the locations for the spikes they saw, but no seizures during the time you were in.

Sleep spindles and the Vertex waves are normal for his age, we have been told.

I am not sure about the alpha amplatude but the Theta slowing might be normal drowsiness since the report did not report that as abnormal for him.....


He did not seem to have any problems with the Photic stimulations or hyperventilation, so that is good.

[q]Impressions
During this study, the baseline EEG was abnormal because of the presence of an active focus of epileptiform activity in the centrotemporal head region (C4, T4) with a wide field of distributions spreading to involve the ipsilateral anterior temporal head region (F8) as well. These findings place this patient at risk for focal and secondarily generalized seizures.[/q]

I guess the most important part is that the impression is that he is still at risk for Seizures that are partial and secondary generalized.

The abnormality is all on the right side in the frontal, and temporal region.

Does this help?

Ginny

Thanks

It does

Donna

Of course one good thing I see is that the Normal Background rhythm rules out the scary encephalopathies. Anterior temporal is the front part of the temporal lobe that is adjacent to the frontal lobe, and according to the way the eeg leads are applied the spiking is all in one area that seems consistent with one clear focal area. I think this is saying that his seizures are coming from one area and then spreading.

I hope this helps.

Ginny