CLINICAL HISTORY:
MEDICATIONS:
INTRODUCTION:  This is a continuation of the day 3 and 4 report on this patient for the dates 03/14/2012 to 03/16/2012.
DESCRIPTION OF THE RECORD:  Day 3:  At the onset of day 3, there is frequent rhythmic runs of sharp waves seen at F7, T1 and at times at T5 that appear to come and go but have no clear evolution.  However, on 03/15 in the morning at 9:30 a.m., the patient appears to suddenly stop talking on the phone, put herself on the side of her left chest and started rubbing her shirt with her right hand.  The nurses at the bedside started asking her questions, and she could not answer.  Then she started staring at the nurse and exhibiting mouth movements while she continued to rub her chest with her hand.  Afterwards, about 20 seconds later, she started rubbing her chest with her left hand and continued to __________with the left hand.  This continues until the seizure and the left hand movement stops seconds later, and then she just stares and remains unresponsive.  This behavior then stops as the seizure stops.  About 2 minutes and 40 seconds after the seizure, the behavior stops and the seizure ends.  During this time, the EEG reveals at about almost 50 seconds after the clinical onset of the seizure there appears to be an evolving T5 discharge which then appears to increase in frequency from 2 to 4 Hz to 6 Hz and moves more anteriorly, then slowing down before stopping at the end of the seizure.  End of day 3.
Day 4:  During day 4, there are multiple nonconvulsive seizures.  The first one is seen at 6:30 p.m. lasting about 4 minutes where the patient is lying in bed and appears to exhibit no movements.  Meanwhile, there is a rhythmic discharge in the left anterior temporal region at F7-T1 that increases and slows down in rhythmicity but continues throughout the recording, at times with larger and smaller superimposed sharp waves.  The next nonconvulsive electrical seizure occurred at 11:31 p.m.  This one appears to begin at T5 and appears to slowly evolve and move more anteriorly to F7-T1.  During it, the patient appears to move but does not clearly appear to exhibit a clinical correlate.  The event ends about 1 minute and 50 seconds later.  End of seizures day 4.
IMPRESSION: