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EEG REPORT Patient: @NAME@ Age: @AGE@ MRN: @MRN@ Date: @ED@ Referring Provider: @REFPROD@ @EEGFLOW(3040141591,3040141592,3040141593,3040141594,3040141595,30401415 96,3040141597,3040141598,3040141599)@ Introduction: This 21 channel standard 10-20 electrode routine {EEG length:304014049} EEG was recorded with video-monitoring for a @AGE@ with a history of ***. This EEG was performed to evaluate for focal and epileptiform abnormalities. Current Medications: @NAME@ @CMEDPBRAND@ The patient {WAS,WAS NOT:23947:o} sleep deprived. Single lead EKG monitoring as well as infraorbital electrodes were included. Description: The dominant background activity during maximal recorded wakefulness consisted of a ***Hz, *** uV {symmetric/unilateral/asymmetric:304014032} {regular/irregular/disorganized:304014033} activity that was {reactive/nonreactive:304001168} to eye opening. ***Reactivity to {EEG reactivity:304014061} stimulation was ***. ***There was {ldprevalence:28138} *** Hz, *** uV, {ldrhythmic:28144}, {ldfrequency:28146} slowing over the {ldRLbilateral:28147} {EEG lobes:304014060} region. ***There were {ldprevalence:28138}, {eeg :77378}, *** uV, {ldmorphology:28145} over the {ldRLbilateral:28147} {EEG lobes:304014060} region. These occurred in {ldrhythmic:28144} *** Hz runs lasting up to *** seconds. ***An electrographic seizure ***. During drowsiness the background rhythm waxed and waned and there were periods of slowing. During stage II sleep symmetric V waves, K complexes, and sleep spindles were seen. There was appropriate diffuse delta activity during slow wave sleep. Activation procedures {activation procedures:304014040}. Photic stimulation – stepwise photic stimulation at 2-30 Hz was performed and evoked {photic stimulation response:304014041}. Hyperventilation – performed for {NUMBERS 1-4:25063} minutes, with {desc; poor/fair/good/excellent:19665} effort by the patient. Changes noted included {hyperventilation changes noted:304014042}. Significant artifacts included {EEG significant artifacts:304014043}. The EKG channel demonstrated {EKG channel:304014044}. Interpretation: This EEG was abnormal because of: 1. ***. 2. ***. 3. ***. Clinical correlation: 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}