CLINICAL HISTORY:  This is a 49-year-old male with refractory epilepsy, temporal lobe epilepsy, admitted with recurrent seizures on the 28th.
MEDICATIONS:  Keppra, Tegretol, phenobarbital, lisinopril.
INTRODUCTION:  Continuous video EEG monitoring was initiated on the 28th using standard 10-20 system of electrode placement with 1 channel EKG.  Seizure and spike detection software was utilized.  No seizures were noted in the patient clinical notes.
DESCRIPTION OF THE RECORD:  As the tracing begins the patient is postictal and the overall pattern is diffusely slow.  Within an hour of the EEG he becomes a bit more awake with a 9 Hz posterior dominant rhythm.
By 9 p.m., he is transitioning in and out of stage 2 sleep.
There is a fair amount of EKG artifact noted. By 11 a.m., the nurse is able to awaken the patient with brief, sustained wakefulness.
No epileptiform discharges were identified.
Heart rate 78 bpm.
IMPRESSION:  This continuous video EEG monitoring was remarkable for background slowing noted in the initial sections of the record.
CLINICAL CORRELATION:  The pattern of resolving background slowing is compatible with a postictal physiology.  No seizures were recorded today.
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