CLINICAL HISTORY:  Patient is a 59-year-old man status post cardiac arrest requiring CPR who subsequently was found to have nonconvulsive status epilepticus on a routine EEG on 12/26/2012.
MEDICATIONS:  Phenobarbital and Depakote.
INTRODUCTION:  The recording was performed according to the standard 10-20 system with additional T1 and T2 electrode and a single EKG lead.
DESCRIPTION OF THE RECORD:  There is no posterior dominant rhythm and no anterior to posterior frequency amplitude gradient.  Early in the recording, the background consists of moderate-amplitude generalized spikes, after-going slow waves, and polyspikes that have frontal predominance and are high in amplitude over the left hemisphere.  These discharges are continuous, occurring at approximately 2 to 2.5 Hz.  Additionally, there are intermittent bursts of generalized, frontally predominant, left-greater-than-right fast activity.  These bursts last from approximately 0.3 seconds to 1 second.
In the second half of the recording, there is gradual decrease in diffuse voltage, epileptiform discharges become less pronounced.  By the end of the recording, generalized low-amplitude sharp waves observed.  Additionally, by the end of the recording, the background consists of frequent periods of discontinuity mixed with nearly continuous ventilator artifact.  Until approximately 9:40 p.m., intermittent seizures are captured.  Seizure frequency is approximately 2-4 seizures per hour early in the recording.  This seizure frequency decreases as the recording progresses with electrographic seizure recorded at approximately 9:39 p.m.  Seizures started with generalized, frontally predominant, left-greater-than-right fast activity.  This fast activity rapidly increases in amplitude and decreases in frequency.  There is no clear clinical correlate during these seizures.  Seizures have an abrupt offset with diffuse postictal slowing and attenuation observed.  Seizures last approximately 20-30 seconds.
FINDINGS:
Intermittent generalized seizures without clear clinical correlate that occur approximately 2-4 times per hour until approximately 9:39 p.m.  Last seizure recorded at approximately 9:39 p.m.
Gradual voltage attenuation and severe diffuse background slowing as the recording progresses.
IMPRESSION:  This is a very abnormal continuous video 24-hour electroencephalogram due to intermittent seizures until approximately 9:40 p.m., gradual background slowing and attenuation as the recording progresses.  These findings indicate progressive, ongoing severe cortical dysfunction that, in a patient with post anoxic brain injury, represents low chance of full neurological recovery.