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AMBULATORY CASSETTE RECORDING EEG MONITORING REPORT
EPILEPSY LABORATORY
CLINICAL NEUROPHYSIOLOGY LABORATORIES
DEPARTMENT OF NEUROLOGY
UNIVERSITY OF MICHIGAN
Patient: @NAME@
Age: @AGEPEDS@
MRN: @MRN@
Date: @ED@
Referring physician: @ORDPROV@
Introduction: The patient is a @AGEPEDS@ @GENDER@ with a history of ***. This
ambulatory cassette recording EEG monitoring study was performed in order to
diagnose the etiology of the patient's clinical events. The patient {IS/IS NOT:27046} on
neuroactive medications.
@NAME@ @CMEDPBRAND@
This recording was obtained using the standard 21-channel 10-20 electrode placement.
Single lead EKG monitoring was included. Video recording was utilized during the
baseline.
Baseline EEG Recording: The baseline was obtained during
{wakefulness_drowsiness_sleep_free:304014064}. In the alert state, the posterior
background rhythm was a symmetric, well-modulated, *** Hz, *** uV rhythm which
reacted symmetrically to eye opening and had a normal frequency-amplitude gradient
with an age-appropriate mixture of frequencies. Hyperventilation, performed with
{desc; poor/fair/good/excellent:19665} effort, produced physiological slowing. Stepwise
photic stimulation at 2-30 Hz evoked symmetric posterior driving responses. No
abnormalities were activated by hyperventilation or photic stimulation. During
drowsiness there were bursts of diffuse slowing and waxing and waning of the posterior
dominant rhythm. During stage II sleep symmetric V waves, K complexes, and sleep
spindles were seen. There were no focal or epileptiform abnormalities and no clinical or
electrographic seizures occurred during the baseline. The EKG channel revealed no
abnormalities.
Day 1 - @ED@
Interictal EEG Samples: During wakefulness and drowsiness, the EEG was as described
above. Interictal EEG samples during stage II sleep demonstrated symmetric V waves, K
complexes, and sleep spindles. The appearance of diffuse delta activity was observed in
slow wave sleep. No abnormalities were activated by sleep.
Ictal EEG Recording / Patient Events: During this period the patient had no events or
seizures.
Summary: During this day of recording *** events were recorded. The interictal EEG
was {EEG abnormal/normal interpretation:304014062}. Monitoring was continued in
order to record the patient’s typical events. The EKG channel revealed no abnormalities.
Day 2 - ***
Interictal EEG Samples: Interictal samples were identical to those previously recorded.
Ictal EEG Recording / Patient Events: During this period the patient had no events or
seizures.
Summary: During this day of recording *** events were recorded. The interictal EEG
was {EEG abnormal/normal interpretation:304014062}. Monitoring was discontinued.
The EKG channel revealed no abnormalities.
Summary of EEG and Behavior: The interictal EEG was {EEG abnormal/normal
interpretation:304014062}. *** of the patient’s typical events were recorded. *** EEG
change occurred during the patient’s clinical event(s).
Clinical Correlation: This *** day EEG recording was a {EEG abnormal/normal
interpretation:304014062} awake and asleep EEG.
***No patterns with a specific correlation with seizures were present, and no focal
abnormalities were found. The patient’s typical episodes were recorded and were
consistent with ***.
*** This EEG was abnormal in {wakefulness_drowsiness_sleep_free:304014064}.
1. ***
2. ***
3. ***
***The disorganized background, with diffuse *** Hz slowing was consistent with a
mild/mild to moderate/moderate/moderate to severe/severe encephalopathy.
***The continuous focal slowing over *** was consistent with an underlying structural
lesion or a post-ictal state.
***The intermittent focal slowing over *** suggested underlying neuronal dysfunction.
The focal sharps/spikes/spike and wave complexes over *** conferred an increased risk
of focal seizures arising from this region.
***The generalized sharps/spikes/spike and wave complexes conferred an increased
risk of seizures with a generalized onset.
***The multifocal sharps/spikes/spike and wave complexes conferred an increased risk
of focal and generalized seizures.
***There were *** seizures recorded, clinically manifesting as ***, and with the
electrographic appearance of ***.
***There were *** events recorded, and there was no abnormal EEG change with these
events. These were not seizures.
***Overall, this EEG is improved/similar/worse compared to a previous EEG recorded
mm/dd/yyyy, because of ***.
***In view of the clinical picture, a recording including sleep/with reactivity testing
repeated/ with longer duration to capture spells, etc. could be useful. A normal
recording does not exclude the possibility of epilepsy, in this clinical setting, repeat
recording could be useful.
@MECREDENTIALNOREFRESH@
Epilepsy Fellow
This EEG was reviewed with epilepsy attending {ldattending:28131}. Please note this is a
preliminary report until signed by the attending.
Clinical Diagnosis Code:
{lddiagnosiscodesICD9-10:28354}