Download clinical neurophysiology laboratories

SHORT-TERM EEG-VIDEO MONITORING REPORT
EPILEPSY LABORATORY
CLINICAL NEUROPHYSIOLOGY LABORATORIES
DEPARTMENT OF PEDIATRICS
UNIVERSITY OF MICHIGAN
Patient: @NAME@
Age: @AGEPEDS@
MRN: @MRN@ Date: @ED@
Referring physician attending: @ORDPROV@
Introduction: The patient is a @AGEPEDS@ {boy/girl:304001889} with a history of ***.
This short-term video-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.
This recording was obtained using the standard 21-channel 10-20 electrode placement.
Single lead EKG monitoring and infraorbital electrodes were included. A number of
standard bipolar and referential montages were used.
Current Medications: @NAME@ @CMEDPBRAND@
Baseline EEG Recording: The baseline recording 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.
There were no focal or epileptiform abnormalities and no clinical or electrographic
seizures occurred during the baseline.
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 by 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.
The EKG channel revealed no abnormalities.
Interictal EEG Samples: During wakefulness, the EEG was as described above. During
drowsiness the background rhythm waxed and waned and there were periods of
slowing. Interictal EEG samples during stage II sleep demonstrated symmetric V waves,
K complexes, and sleep spindles. There was appropriate diffuse delta activity during
slow wave sleep. No abnormalities were activated by sleep.
The EKG channel revealed no abnormalities.
Ictal EEG Recording / Push-Button Events: During this period the patient had no events
or seizures.
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 *** hour short-term 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 due to the following:
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}