Pediatric Generalized Epilepsy Long Term Monitoring
Primary (Genetic) Generalized Epilepsy in a Pediatric
Patient: Characterizing Infrequent Generalized Seizures and Sleep-Activated Discharges via Extended Video-EEG Monitoring
Patient History
The 11 year old male patient had seizures since the age of 2.8 years. Birth history: NVD at term, birth weight 2.5 kg, cried immediately after birth. Developmental milestones were normal. Seizure semiology: No aura reported. Episodes typically involve deviation to the right side during the night, lasting about 1–2 minutes, usually occurring during sleep onset or in a drowsy state. Post ictal drowsiness lasts approximately 10 minutes. Frequency: 1–2 episodes per year. Last attack occurred 1 month ago. There is no family history of seizures, no history of head trauma, and no previous surgery. The patient has a right ear malformation. Current antiepileptic medications (AEDs): Zenoxa and Lacosamide. MRI brain was reported as normal, and previous EEG recordings were also normal. Mocxa long-term Video EEG monitoring was performed in the hospital. Mocxa’s capability for extended monitoring periods was crucial for capturing infrequent seizure events in this patient.
Procedure Details
| Location | Home |
| Duration | 24 Hours |
| EEG Type | Ambulatory, 24 Channels, With ECG, With Video |
Report
Description: Awake record showed posterior dominant rhythm of 8–9 Hz over the bilateral posterior head regions, well reactive to eye-opening and mental alertness. Sleep record consisted of a mix of theta and delta waves, with occasional bursts of higher frequency 12–14 Hz activity sleep spindles. Symmetric sleep spindles, vertex waves and K-complexes were noted. IEDs: Epileptiform abnormalities in the form of frontally dominant generalized spike, polyspikes and wave discharges were noted during wakefulness with increased activation in sleep. Seizures: Recorded 1 seizure with clinical semiology: the patient was lying in bed in the right lateral position and was noted to have sustained posturing of the left upper limb with altered sensorium. EEG: Diffuse burst of frontally dominant generalized polyspikes, followed by attenuation, followed by bilateral PHR evolution of fast spike and wave discharges, and synchronization.
Impression: This EEG record showed bifrontal and generalized epileptiform abnormalities. Recorded 1 generalized seizure of diffuse ictal onset. The presence of normal background activity, activation in sleep and morphology of discharges suggests a probable diagnosis of Primary (Genetic) generalized epilepsy.