Date of Procedure: Date started: 02/24/2009
Date completed: 02/25/2009
Procedure: 23-hour Video Monitor Recording
Clinical History: This is a 3 yr old child with a history of bilateral perisylvian syndrome, infantile spasms.
Medications: Vigabatrin, continued during the recording
Recording Date: The scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital EEG system.
Digital EEG Analysis: The automatic seizure-spike detection programs were applied.
Findings: Background activity: The background activity during the awake state consisted of posterior dominant theta activity at 5 Hz. No consistent focal slowing or inter hemispheric asymmetry was noted. During sleep, sleep spindles were noted bilaterally.
Interictal Findings: frequent spikes as well as runs of spike were seen in the left frontal-central-temporal regions involving electrodes F7, T3, and C3, which occasionally showed secondary bilateral synchrony. Additionally, independent spikes were also frequently noted int he right temporal-central-parietal regions. The frequency of interictal epileptiform discharge were more dominant in the left hemisphere and tend to increase while the patient was asleep. However, no ongoing seizures were captured.
Clinical Events: No paroxysmal events were recorded by the family.
Impression: This was a normal video monitor recording.
1) The background activity was diffusely slow for age suggesting diffuse neuronal dysfunction.
2) The presence of frequent interictal spike in the left frontal-central-temporal as well as right temporal-central-parietal which was more dominant in the left hemisphere particularly while the patient was asleep suggested increased risk of epileptic seizure with multi-focal onset.
3) No ongoing seizures or habitual events were captured during the recording.
Showing posts with label EEG. Show all posts
Showing posts with label EEG. Show all posts
Wednesday, February 25, 2009
Monday, January 26, 2009
Video Monitoring Recording
Date of Procedure: Date started: 01/12/2009
Date completed: 01/13/2009
Procedure: 23-hour Video Monitor Recording
Clinical History: This is a 3 yr old child with a history of bilateral perisylvian syndrome, infantile spasms, now having startle episodes again.
Medications: None
Recording Date: The scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital EEG system.
Digital EEG Analysis: The automatic seizure-spike detection programs were applied.
Findings: Background activity: The background activity during the awake state consisted of posterior dominant theta activity at 5-6 Hz which was bilaterally symmetrical.
During sleep, sleep spindles were seen bilaterally.
Interictal Findings: Interictally there was presence of right temporal-central as well as right temporal-central spike and wave activity seen.
Clinical Events: There were spasms captured. These spasms showed minimal EEG correlation or sometimes the EEG correlation was obscured by EMG activity. Some spasms showed diffuse spike wave activity followed by attenuation. We would not localize the seizure onset..
Impression: This is an abnormal video EEG monitoring. The background activity is slow for age which suggests diffuse neuronal dysfunction. There is present of multi-focal spike and wave activity as well as multiple spasms captured during the recording.
Date completed: 01/13/2009
Procedure: 23-hour Video Monitor Recording
Clinical History: This is a 3 yr old child with a history of bilateral perisylvian syndrome, infantile spasms, now having startle episodes again.
Medications: None
Recording Date: The scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital EEG system.
Digital EEG Analysis: The automatic seizure-spike detection programs were applied.
Findings: Background activity: The background activity during the awake state consisted of posterior dominant theta activity at 5-6 Hz which was bilaterally symmetrical.
During sleep, sleep spindles were seen bilaterally.
Interictal Findings: Interictally there was presence of right temporal-central as well as right temporal-central spike and wave activity seen.
Clinical Events: There were spasms captured. These spasms showed minimal EEG correlation or sometimes the EEG correlation was obscured by EMG activity. Some spasms showed diffuse spike wave activity followed by attenuation. We would not localize the seizure onset..
Impression: This is an abnormal video EEG monitoring. The background activity is slow for age which suggests diffuse neuronal dysfunction. There is present of multi-focal spike and wave activity as well as multiple spasms captured during the recording.
Wednesday, July 25, 2007
Video Monitoring Recording
Date of Procedure: Date started: 06/28/07
Date completed: 06/29/07
Procedure: 24-hour Video Monitor Recording
Clinical History: This is a 22 month old male with seizure like episodes
Medications: Vigabatrin and Zonegran
Recording Date: The scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital EEG system.
Digital EEG Analysis: The automatic seizure-spike detection programs were applied.
Findings: Background activity: The background activity during the awake state consisted of posterior dominant theta activity at 5-6 Hz. No consistent background asymmetry was noted. Frequent independent spike and wave activity was noted in the left and right temporal region independently. The frequency of interictal spike and wave activity were higher on the left side. The frequency of interictal epileptiform activity was increased during sleep. Some of the spike and wave activity in the left temporal region showed secondary bilaterally synchrony.
During sleep, vertex waves, sleep spindles were noted bilaterally.
Interictal Findings: No electrographic seizures were captured on this recording.
Clinical Events: A total of six clinical events were documented by the family. The events consisted of either startling (brief body stiffening) or rapid eye twitching. None of the events showed significant evolution of epileptiform activity on EEG. No subclinical seizures were captured.
Impression: This is an abnormal video EEG monitoring. The background activity was within lower normal limits. Independent spike and wave activity in the left and right temporal regions may suggest increase risk of epileptic seizures. Otherwise, no subclinical seizures were captured. No electrographic seizures were captured. None of the clinical events showed EEG correlations. Therefore, these episodes are probably nonepileptic events.
Date completed: 06/29/07
Procedure: 24-hour Video Monitor Recording
Clinical History: This is a 22 month old male with seizure like episodes
Medications: Vigabatrin and Zonegran
Recording Date: The scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital EEG system.
Digital EEG Analysis: The automatic seizure-spike detection programs were applied.
Findings: Background activity: The background activity during the awake state consisted of posterior dominant theta activity at 5-6 Hz. No consistent background asymmetry was noted. Frequent independent spike and wave activity was noted in the left and right temporal region independently. The frequency of interictal spike and wave activity were higher on the left side. The frequency of interictal epileptiform activity was increased during sleep. Some of the spike and wave activity in the left temporal region showed secondary bilaterally synchrony.
During sleep, vertex waves, sleep spindles were noted bilaterally.
Interictal Findings: No electrographic seizures were captured on this recording.
Clinical Events: A total of six clinical events were documented by the family. The events consisted of either startling (brief body stiffening) or rapid eye twitching. None of the events showed significant evolution of epileptiform activity on EEG. No subclinical seizures were captured.
Impression: This is an abnormal video EEG monitoring. The background activity was within lower normal limits. Independent spike and wave activity in the left and right temporal regions may suggest increase risk of epileptic seizures. Otherwise, no subclinical seizures were captured. No electrographic seizures were captured. None of the clinical events showed EEG correlations. Therefore, these episodes are probably nonepileptic events.
Saturday, November 18, 2006
Video EEG
Date of Procedure: November 18, 2006
CLINICAL HISTORY: D is a 15 month male born at full-term with history of infantile spasms and developmental delay
RECORDING DATA: Scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital system.
DIGITAL EEG ANAYSIS: Automatic spike and seizure detection programs were applied.
Background activity: The background during the awake state consisted of a mixture of felta, theta, and alpha activities ranging from 4-7 Hz, which was bilaterally symmetrical. During sleep, the background consisted of a mixture of delta and theta activity ranging from 2-5 Hz. Sleep spindles, vertex waves, and K complexes were seen bilaterally.
INTERICTAL FINDINGS: Occasional spike and wave activity was seen in the right temporal-partietal-occipital region and independently occasionally spike and wave activity was seen at left temporal-parietal-occipital region. No ongoing seizure was noted.
CLINICAL EVENTS: A total of 10 events were recorded by the parents. These events were characterized by rapid eye blink. None of these episodes showed evolution of epileptiform activity.
IMPRESSION: This was an abnormal video monitoring recording.
1) The background was slow. This finding may suggest diffuse neuronal dysfunction.
2) Occasional spike and wave activity was seen in the tight temporal-parietal occipital region and independently occasional spike and wave activity was seen in the left temporal parietal occipital region. These findings may suggest increased risk of epileptic seizures.
3) A total of 10 events were recorded by the parents. These events were characterized by rapid eye blink and staring. None of these episodes showed evolution of epileptiform activity so therefore; these events were probably nonepileptic in nature.
Clinical correlation was suggested.
CLINICAL HISTORY: D is a 15 month male born at full-term with history of infantile spasms and developmental delay
RECORDING DATA: Scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the Nihon Kohden digital system.
DIGITAL EEG ANAYSIS: Automatic spike and seizure detection programs were applied.
Background activity: The background during the awake state consisted of a mixture of felta, theta, and alpha activities ranging from 4-7 Hz, which was bilaterally symmetrical. During sleep, the background consisted of a mixture of delta and theta activity ranging from 2-5 Hz. Sleep spindles, vertex waves, and K complexes were seen bilaterally.
INTERICTAL FINDINGS: Occasional spike and wave activity was seen in the right temporal-partietal-occipital region and independently occasionally spike and wave activity was seen at left temporal-parietal-occipital region. No ongoing seizure was noted.
CLINICAL EVENTS: A total of 10 events were recorded by the parents. These events were characterized by rapid eye blink. None of these episodes showed evolution of epileptiform activity.
IMPRESSION: This was an abnormal video monitoring recording.
1) The background was slow. This finding may suggest diffuse neuronal dysfunction.
2) Occasional spike and wave activity was seen in the tight temporal-parietal occipital region and independently occasional spike and wave activity was seen in the left temporal parietal occipital region. These findings may suggest increased risk of epileptic seizures.
3) A total of 10 events were recorded by the parents. These events were characterized by rapid eye blink and staring. None of these episodes showed evolution of epileptiform activity so therefore; these events were probably nonepileptic in nature.
Clinical correlation was suggested.
Monday, April 24, 2006
Video EEG
Date of Procedure: April 24, 2006
CLINICAL HISTORY: Patient is a 8 month old male with history of infantile spasms. Patient is now having daily episodes of blank staring where the patients pupils were dilated.
Medications: Current medications include Vigabatrin
RECORDING DATA: Scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the stellate digital system.
DIGITAL EEG ANALYSIS: Automatic spike and seizure detection programs were applied.
Findings: background activity: the awake background activity showed posterior dominant delta activity at 2Hz, which were reactive to eye opening and eye closure. No significant background asymmetry was seen. No focal slow wave activity was seen. During the sleep state, mixtures of 1-3 Hz delta and 4-6 Hz theta activities were noted. Sleep spindles and vertex waves appeared bilaterally. Some portions of sleep EEG resembled hypsarrhythmia.
INTERICTAL FINDINGS: Interictally, there was frequent spike wave activity in the right temporal region involving t4-t6. In addition, there was frequent independent spike activity in the left temporal-central-parietal region involving t5-t3-p3. There was also occasional independent spike wave activity in the bilateral occipital regions involving o1-o2-oz..
CLINICAL EVENTS: One cluster of habitual seizures was captured. The seizure occurred on day 1A-3 at 11:05. the seizure occurred during the awake state and was characterized by slight dilation of the pupils and subtle body jerks. the cluster consisted of six spasms and lasted 10 minutes.
ICTAL EEG FINDINGS: Ictal EEG showed diffuse slow-wave activity with minimal superimposition of fast wave activities.
IMPRESSION: This is an abnormal one day video monitor recording. The overall background activity was slow for age. In addition, some portions of sleep EEG resembled hypsarrhythmia. These findings may suggest diffuse neuronal dysfunction. Interictally, there were frequent independent spike wave activities in the right temporal region as well as in the temporal-central-parietal region. There was also occasional independent spike wave activity in the bilateral occipital regions. These findings may suggest increased risk of epileptic seizures arising from these bilateral multiple foci. We captured one cluster of habitual epileptic spasms. The seizure occur ed during the awake state and consisted of subtle body jerks associated with slight dilation of the pupils. Ictal EEg showed diffuse seizure onset.
The interictal and ictal EEg findings were consistent with the diagnosis of infantile spasms. The habitual events that the patient is having may be subtle epileptic spasms. Clinical and neuroimaging correlation is recommended.
CLINICAL HISTORY: Patient is a 8 month old male with history of infantile spasms. Patient is now having daily episodes of blank staring where the patients pupils were dilated.
Medications: Current medications include Vigabatrin
RECORDING DATA: Scalp electrodes were applied according to the International 10/20 system of electrode placement. Zygomatic electrodes were also used. The recording was made on the stellate digital system.
DIGITAL EEG ANALYSIS: Automatic spike and seizure detection programs were applied.
Findings: background activity: the awake background activity showed posterior dominant delta activity at 2Hz, which were reactive to eye opening and eye closure. No significant background asymmetry was seen. No focal slow wave activity was seen. During the sleep state, mixtures of 1-3 Hz delta and 4-6 Hz theta activities were noted. Sleep spindles and vertex waves appeared bilaterally. Some portions of sleep EEG resembled hypsarrhythmia.
INTERICTAL FINDINGS: Interictally, there was frequent spike wave activity in the right temporal region involving t4-t6. In addition, there was frequent independent spike activity in the left temporal-central-parietal region involving t5-t3-p3. There was also occasional independent spike wave activity in the bilateral occipital regions involving o1-o2-oz..
CLINICAL EVENTS: One cluster of habitual seizures was captured. The seizure occurred on day 1A-3 at 11:05. the seizure occurred during the awake state and was characterized by slight dilation of the pupils and subtle body jerks. the cluster consisted of six spasms and lasted 10 minutes.
ICTAL EEG FINDINGS: Ictal EEG showed diffuse slow-wave activity with minimal superimposition of fast wave activities.
IMPRESSION: This is an abnormal one day video monitor recording. The overall background activity was slow for age. In addition, some portions of sleep EEG resembled hypsarrhythmia. These findings may suggest diffuse neuronal dysfunction. Interictally, there were frequent independent spike wave activities in the right temporal region as well as in the temporal-central-parietal region. There was also occasional independent spike wave activity in the bilateral occipital regions. These findings may suggest increased risk of epileptic seizures arising from these bilateral multiple foci. We captured one cluster of habitual epileptic spasms. The seizure occur ed during the awake state and consisted of subtle body jerks associated with slight dilation of the pupils. Ictal EEg showed diffuse seizure onset.
The interictal and ictal EEg findings were consistent with the diagnosis of infantile spasms. The habitual events that the patient is having may be subtle epileptic spasms. Clinical and neuroimaging correlation is recommended.
Tuesday, February 7, 2006
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
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
Friday, January 20, 2006
EEG Report 30 Minute 01/20/06
Age at test: 5 months old
Sixteen channel EEg performed on this patient using the standard complement of electrodes and utilizing the 10-20 system of electrode placement.
Findings: The patient was awake at the onset of the recording. The background consisted of mixed frequency activity non reactive activity in the posterior and rolandic head regions. There was some 4-5Hz polymorphic theta seen. the Child did become drowsy with diffuse 5-6 Hz theta but did not enter sustained sleep with sleep spindles and V waves. There was no definite epileptiform acticity seen. Movement and EMG artifact ws noted. No asymmetry seen. There were generalized burts of high amplitude sharp waves and spike and waves, follwered by periods of attenuation. There were also independent spike and shart waves seen in a multifocal manner.
Hyperventilation: Not performed
Photic Stimulation: Produced bioccipital recruitment at some flash frequencies.
Clinic comment: This EEG is abnormal for the age of child during the awake state with mild to moderate diffuse neuronal dysfunction. the generalized paroxysmal activity described above can have the potential for generalized seizures. No epileptiform activity or lateralizing features seen. Clinical correlations recommended.
Sixteen channel EEg performed on this patient using the standard complement of electrodes and utilizing the 10-20 system of electrode placement.
Findings: The patient was awake at the onset of the recording. The background consisted of mixed frequency activity non reactive activity in the posterior and rolandic head regions. There was some 4-5Hz polymorphic theta seen. the Child did become drowsy with diffuse 5-6 Hz theta but did not enter sustained sleep with sleep spindles and V waves. There was no definite epileptiform acticity seen. Movement and EMG artifact ws noted. No asymmetry seen. There were generalized burts of high amplitude sharp waves and spike and waves, follwered by periods of attenuation. There were also independent spike and shart waves seen in a multifocal manner.
Hyperventilation: Not performed
Photic Stimulation: Produced bioccipital recruitment at some flash frequencies.
Clinic comment: This EEG is abnormal for the age of child during the awake state with mild to moderate diffuse neuronal dysfunction. the generalized paroxysmal activity described above can have the potential for generalized seizures. No epileptiform activity or lateralizing features seen. Clinical correlations recommended.
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