CLINICAL HISTORY: This is a 50-year-old male with left frontal tumor status-post resection.  Admitted for increased multiple seizures. Patient had multiple seizures over the last 48-hour long-term EEG monitoring.  Due to the frequency of the non-convulsive epilepsy, the patient was transported to the ICU today and continues on long-term monitoring.
MEDICATIONS: Dilantin and Phenobarbital.  
INTRODUCTION: Digital video EEG is performed at the bedside in the Long-Term EEG Monitoring unit using standard 10-20 system of electrode placement with one channel of EKG. Hyperventilation and photic stimulation were not performed.  This is an awake through stage II sleep record. 
DESCRIPTION OF THE RECORD: The background EEG is continuous, disorganized with excessive slow theta and delta activity.  There is a nearly continuous left frontocentral and temporal arrhythmic and polymorphic delta activity.  At times the sharp activity is also seen in this area.  The digital camera did not record any physical seizures, however, several non-convulsive electrographic epileptic discharges were identified.  
EVENTS: The patient had several episodes of electrographic seizures without convulsions including at 07:36, 08:00, 12:04, 12:06, 12:43, 13:24, 13:46, 14:12, and 15:37.  Electrographically, sharply contoured activity initially emanates from the left central area and then generalized to involve the entire cortex diffusely.  At that time, a 4 to 5 Hz, spike and slow wave activity with diffuse muscle activity is seen, lasting for about three minutes before subsiding. Continuous sharply contoured activity and some sharp and spike waves with slow wave complexes are still seen in the left frontocentral area.  Clinically and on the video camera, the patient gradually turns his head to the right with occasional flexion of both arms, but most often with the right arm.  When the epileptiform discharges stop, both arms return to their normal position.  In some episodes, the patient can even answer questions from his family, the nurse, or doctor.  All spells had similar manifestations and EEG features.  
HR:  72 BPM.
	IMPRESSION: Abnormal EEG due to:
	1.	Frequent electrographic epileptiform discharges. 
CLINICAL CORRELATION: This patient’s clinical manifestations and EEG features are consistent with non-convulsive status.  These results were communicated to the primary team and the patient was transferred to the ICU for intensive care and therapy.