Focal Seizures Long Term Monitoring
Symptomatic Localization-Related Epilepsy of Right Temporal Neocortical Origin: Localizing Focal Seizures via Extended Video-EEG Monitoring
Patient History
The 27 year old male patient had a seizure at 6 months of age – fever with encephalitis and took AED for 5 years. Seizure recurrence since 2019. Aura – perioral movement and later GTCS. Last – 10 – 15 minutes. Post ictal drowsiness – 30 minutes. Frequency 8–10 episodes per year. Last attack – 2 months ago. No family history, No head trauma. Current medicine – Oxetol, Licotar, Levetricetam. MRI – Normal, EEG – Awake record – Normal, EEG – Right focal persistent spike and slow wave. Mocxa long term Video EEG was done in a hospital. Mocxa’s capability for extended monitoring periods enabled accurate capture.
Procedure Details
| Location | In-patient |
| Duration | 27 Hours |
| EEG Type | Ambulatory, 24 Channels, With ECG, With Video |
Report
Background activity: Awake record showed posterior dominant rhythm of 8–9hz over the bilateral posterior head regions, well reactive to eye-opening and mental alerting. Sleep record consists of a mix of theta and delta waves, with occasional bursts of higher frequency 12–14hz activity sleep spindles. Symmetric sleep spindles, vertex waves and K-complexes were noted. Focal intermittent theta-delta slowing was noted over the right frontotemporal region.
IEDs: Epileptiform abnormalities in the form of spike and sharp wave discharges were noted over the right frontotemporal region during wakefulness, with increased activation in sleep.
Seizures: Recorded 2 stereotyped seizures.
Semiology: Behavior arrest, vacant stare, confusion, chewing automatisms, forced head deviation to left, left ATLP and secondary generalisation, last clonic jerk was noted in the right upper limb.
EEG: Right frontotemporal polymorphic theta, spiky theta, right frontotemporal followed by right hemispheric evolution of fast spike and wave discharges, secondary bilateral synchrony.
Impression: This EEG record showed focal epileptiform abnormalities over the right fronto-temporal region, in addition to focal intermittent non-specific electrophysiological dysfunction over the same region. Recorded 2 events of right anterior temporal ictal onset. Overall data is suggestive of symptomatic LRE of right temporal neocortical origin.