CLINICAL HISTORY:  A 64-year-old woman with previous aneurysm, repair, right cerebral infarct, left sided weakness and seizures.  Previously 2 times per week, now increasing seizures.  Prolonged hospitalization in 2008 for intraventricular hemorrhage, intracerebral hemorrhage requiring tracheostomy.
MEDICATIONS:  Keppra, Trileptal.
INTRODUCTION:  Digital video EEG was performed in the lab using standard 10-20 system of electrode placement with one channel of EKG.  Photic stimulation was completed.  Hyperventilation was not possible.
DESCRIPTION OF THE RECORD:  In wakefulness, there is 10 Hz alpha rhythm on the left and the left hemisphere is relatively well organized.  The right hemisphere demonstrates significant disruption of faster frequency activity.  Slowed wave forms including primarily delta but some theta were noted.
Photic stimulation was performed early in the record eliciting a driving response on the left but not the right.  Subtle sharp waves were noted at T4, T6 and T2 with rare sharp waves noted in each of these locations.
Heart rate:  78 beats per minute.
IMPRESSION:  This is the fourth EEG for this patient since 2008.  Over the years, there has been a marked improvement in the background from the left.  The focal slowing from the right has been previously described.  In comparison to a study in July 2012, there are significantly fewer sharp waves noted.