LENGTH OF THE RECORDING:  Twenty-five minutes.
CLINICAL HISTORY:  The patient is a 42-year-old man who seizures since childhood, who now presents with increase in seizure frequency.
MEDICATIONS:  Tegretol, Depakote, and Ativan given at an outside emergency room.
CONDITIONS OF THE RECORDING:  The recording was performed according to the standard 10-20 system with additional T1 and T2 electrodes and a single lead EKG lead.  Hyperventilation and photic stimulation were performed.
DESCRIPTION OF THE RECORD:  There is no posterior dominant rhythm and no anterior to posterior frequency amplitude gradient.  The background consists of polymorphic low to moderate amplitude diffuse theta admixed with occasional delta.  During sleep, the degree of delta increases.  Brief bifrontal fast activity is captured.  A single electrographic seizure is captured.  Clinically, it occurs out of sleep when the technologist wakes up the patient for hyperventilation.  During the seizure, the patient does not respond and appears to have possible right hand systemic posturing.  Electrographically, there is rapid diffuse voltage attenuation and appearance of diffuse fast activity that is most pronounced bifrontally.  The seizure lasts approximately 35-40 seconds.  Hyperventilation is performed with poor effort and does not result in significant change in the background.  Photic stimulation does not result in additional abnormalities.
FINDINGS:
Mild to moderate diffuse slowing.
Occasional bifrontal brief fast activity.
A single clinical and electrographic seizure out of wakefulness of unclear lateralization, possibly bifrontal in onset.
IMPRESSION:  This is a very abnormal 25-minute awake and asleep EEG due to mild to moderate diffuse slowing, bifrontal fast activity that is likely to be epileptiform in nature, and a single approximately 40 second seizure out of sleep of unclear lateralization, possibly frontal in onset.  Diffuse slowing indicates nonspecific cerebral dysfunction.   Epileptiform discharges and seizure indicate near cortical origin of the patient's epilepsy.  These findings were conveyed to the neurology primary team at the time of the review.