CLINICAL HISTORY:  56  year old right handed woman with question of epileptic versus nonepileptic features followed by postictal confusion.
MEDICATIONS:  Lisinopril, Paxil, Plavix, ASA, Depakote.
INTRODUCTION:  Digital video EEG was performed in lab using standard 10-20 system of electrode placement with 1 channel of EKG.  Photic stimulation was completed.
DESCRIPTION OF THE RECORD:  In wakefulness, there is a 9 Hz alpha rhythm.  Drowsiness is characterized by slowing of the background with attenuation of alpha rhythm.  Photic stimulation elicits bilateral driving. The patient had a behavior event at 3:28:24.  She is resting comfortably.  She starts her head initially subtly and then more prominently.  Head movements are to the right, then to the left, and then back and forth.  She vocalizes later during seizure as if she is having trouble breathing and then has a yelp at the end of the seizure.  The seizure ends at 3:29:34.  There is no postictal slowing and she drifts off to sleep afterwards.
HR:    78 bpm, rare PVCs.
IMPRESSION:  Normal EEG.
CLINICAL CORRELATION:  The behavior in question was not associated with epileptiform activity.  In addition, the characteristics of the behavior were suggestive of a nonepileptic seizure. This is the 6th EEG for this patient prior EEGs demonstrated similar findings.