24 hr. Video EEG

*Final Report*

Date of Test: 02/07/2006

Procedure: Video Monitor Recording

Clincal History: A 6 month old male who is being evaluated for infantile spasms

Medications: Medications at this time include Topamax

Recording Data: This is a video EEG study using a 32 channel EEg system with simulatneous video recording. An even button was used by the mother to identify suspicious episodes

Findings: background activity: This study lasted 24 hours. The background activity was chaotic with no organization. No definite posterior rhythm could be identified. The amplitude was high ranging between 100 and 400 mcv. Frequent spike wave complexes were seen in a multifocal distribution and generalized polyspike and wave dischanges were also noted. The event button was pressed twice. The fist awas at 21:15 when the patient had woken up from sleep. There was a cluster lasting 3-4 minutes compromising of very mild spasms involving the head, trunk, and the legs. Each spasm was associated with a slow giant wave with superimposed fast wave activity. There were about 20 spasms in this cluster. The event button was pressed again at 2:40 a.m. when an arousal was noted and mild spasms in association with crying and giant waves.

Impression: This is a several abnormal recording. It is significant for a positive diagnosis of infantile spasms, since typical events were captured. However, these spasms were attenuated possibly because of medical treatment. In addition, the chaotic high amplitude background with multifocal spikes is consistent with the electrophysiological diagnosis of hypsarrhythmia