CLINICAL HISTORY: 36 year old right handed woman with new onset seizures characterized by right leg jerking movements and unresponsiveness. History of anxiety disorder. First ever seizure on 9/29/2010.

MEDICATIONS: None.

INTRODUCTION: Digital video EEG was performed in lab using standard 10-20 system of electrode placement with 1 channel of EKG. The patient reports feeling anxious at the start of the study. Hyperventilation and photic stimulation are performed.

DESCRIPTION OF THE RECORD: As the background EEG opens, the patient has generous background beta. There is an 11 Hz alpha rhythm with rhythmic activity in the right temporal region. For some reason, there is a pause in the EEG at the beginning of the record. The patient is staring forward. When the EEG resumes at 1:27:01, there is artifact, but the minute that the artifact stops, the EEG demonstrates a clear, high amplitude, right anterior temporal seizure with 4 to 5 Hz activity in the right temporal region with an admix spike.

The activity is extremely high amplitude with a phase reversal at F8 and T2. The activity ends abruptly at 1:38:56. The overall duration of the seizure appears to be approximately 3 minutes but the seizure onset is unclear. By the end of the seizure, the activity is involving the right frontal region and also the midline and to a lesser extent the left frontal region.

Immediately afterward, the patient is able to answer questions but is amnestic for the event. Following the seizure, occasional arrhythmic delta activity is seen in the right temporal region with a complex. The patient drifts into stage II sleep with vertex waves, K complexes, spindles and posts. The patient is in stage II sleep during photic stimulation.

HR: 72 bpm

IMPRESSION: Abnormal EEG due to:
1. Complex partial seizure from the right temporal region.
2. Right temporal sharp waves.
3. Rhythmic slowing from the right temporal region noted prior to the seizure.