CLINICAL HISTORY:  Rasmussen's encephalitis with breakthrough seizures.
MEDICATIONS:  Keppra, IVIG, phenobarbital, Klonopin, others.
INTRODUCTION:  Continuous video EEG monitoring is performed in the unit.  During a section of the record, the patient has approximately 40 simple partial seizures, all characterized by involuntary movements on the right.  Other seizures can occur out of sleep, but in this 24-hour section almost all the seizures seem to wake him up and are associated with right-sided shaking.
The seizures have variable patterns, but all localize to the left hemisphere.  Some seem to start with a beta buzz in the left central region, others with more higher amplitude spike and wave activity.  The interictal activity includes a pattern with excess beta and theta from the right hemisphere.  The left hemisphere demonstrates __________ delta and the epileptiform activity interictally is more of a polyspike activity in the left posterior temporal region or central parietal region.
Heart rate 80 bpm.
There is no impression or clinical correlation because there are more days to dictate.