Absence seizure eeg
These went unnoticed as they were never witnessed by the family. 1), which lasted 7 seconds and coincided with the patient's disconnection from his surroundings and oral automatism.Ī discussion of the patient's clinical history with family members revealed that his school teacher had complained of frequent “distractions” in class when the patient was 14 years old. The reading displayed a generalised, synchronous, symmetrical 3.5-Hz spike-and-wave discharge ( Fig. The patient's diagnosis was reconsidered due to the exacerbation caused by the latter 2 drugs, and a video EEG was performed, successfully recording a seizure. Drugs administered were: clonazepam, lamotrigine, and valproate, which did not achieve seizure control oxcarbazepine, perampanel, and pregabalin, which were withdrawn due to adverse effects and carbamazepine and lacosamide, which increased seizure frequency. The patient was treated with various antiepileptic drugs, both in monotherapy and in combination therapy.
EEGs were performed on 3 occasions, always displaying normal readings. Given the symptoms described, the patient was diagnosed with temporal lobe epilepsy (with complex partial seizures).Ī brain magnetic resonance imaging scan yielded normal results, as did a blood test with complete blood count studies of liver function, iron metabolism, and kidney function and an autoimmune study. The physical examination revealed no pathological findings. These episodes featured no associated sensory aura, dystonic posture, or tonic-clonic seizures and occurred approximately 4 times per day the patient had no memory of the event. The patient was a 45-year-old man who was referred from another hospital, with no relevant family history 15 years earlier, he had developed recurrent “disconnections” from his surroundings accompanied by occasional oral automatism, lasting approximately 5 seconds, during which posture was maintained. We present a case which demonstrates the potential difficulty of evaluating an adult patient with absence seizures, in which treatment and “resetting” the clinical history were a help in correctly diagnosing the condition and selecting an appropriate treatment. For this reason, video electroencephalography (EEG) monitoring is invaluable in the diagnosis, classification, and treatment of epilepsy. In clinical practice, one-third of focal seizures with cognitive alterations are not controlled by antiepileptic drugs, with misdiagnosis remaining common. Witness accounts of the characteristics of a convulsive seizure serve as the basis for the diagnosis, classification, and treatment of epileptic syndromes however, no such account is available in many cases.