CLINICAL HISTORY: 19 year old right handed male with a past medical history of seizures since age 16, now presents with 2 to 4 a month with loss of consciousness and tonic-clonic shaking.
MEDICATIONS:  Tegretol
REASON FOR STUDY:  Seizures.
INTRODUCTION:  Digital video EEG was performed using standard 10-20 electrode placement system with additional anterior temporal and single-lead EKG electrodes.  The patient was recorded in wakefulness and sleep.  Activating procedures were performed including photic stimulation and hyperventilation.
TECHNICAL DIFFICULTIES:  Some CZ electrode artifact.
DESCRIPTION OF THE RECORD:  The record opens to a well-defined posterior dominant rhythm of 9 to 10 Hz which is reactive to eye opening.  There is normal frontocentral beta.  The patient is recorded in wakefulness and drowsiness.  Activating procedures were performed.  Photic stimulation produced no abnormal discharges; however, some abnormal discharges are seen during hyperventilation; see below.
ABNORMAL DISCHARGES:  During the recording, there are various bursts of generalized slowing at 2 to 4 Hz; however, intermixed with this slowing there are discrete bursts of well-formed generalized spikes and waves at a frequency of 4.5 to 5 Hz with a very high amplitude of about 80 to 100 microvolts.  These bursts last a maximum of 3 to 4 seconds and the patient appears to be able to count during them.  There does not appear to be any clear asymmetry, either.
SEIZURES:  None.
IMPRESSION:  Abnormal EEG due to:
Bursts of generalized spike and wave.
CLINICAL CORRELATION:  This EEG is consistent with a diagnosis of idiopathic generalized epilepsy.  No seizures were seen.