施設により色々ですが, ご参考までに
nonepileptiform abnormalitiesは, evolutionのない徐波,
epileptiform abnormalitiesは, 棘波, 鋭波, 多棘徐波, paroxysmal fast activityといった感じです.
てんかん性異常と判断が難しい鋭い波形は, 鋭一過性波 (sharp transient) として, nonepileptiform abnomalitiesの方に記載しています.
【VEEG Findings】
Posterior background activity: Symmetric, 7–8 Hz.
Sleep structure: No obvious sleep waves were recorded.
Interictal nonepileptiform abnormalities: Intermittent, irregular, generalized slow waves (2–3 Hz).
Interictal epileptiform abnormalities: None.
Ictal recording: None.
【VEEG Findings】
Antiseizure medication: VPA and PER were reduced from July –, discontinued on July –, and then reinstated to baseline from July –. Sleep deprivation was performed.
Background activity: Symmetric posterior background rhythm at 7 Hz.
Sleep structure: Symmetric.
Interictal nonepileptiform abnormalities: Intermittent rhythmic slowing (IRS), generalized.
Interictal epileptiform abnormalities: Spikes and generalized polyspikes, generalized (both observed with or without perioral myoclonus). The frequency of interictal epileptiform discharges (IEDs) was highest immediately after awakening.
Ictal recording:
- Clinical seizure: Generalized myoclonic-clonic seizure
- Clinical description: Sudden staring -> trunk shaking and stiffening
- Lateralizing signs: None
- EEG seizure: Generalized
- EEG description: Rhythmic generalized delta activity -> generalized spike-and-wave discharges (2–3 Hz)
【VEEG Findings】
Interictal nonepileptiform abnormalities:
- Sharp waves observed at left anterior temporal–frontal pole (Lt aT–Fp)
- Sharp wave at right frontal region (Rt F)
Interictal epileptiform discharges (IEDs) were frequent during sleep, occurring 99% on the left side. Only one IED was observed on the right.
Ictal recording:
Seizure 1
- Clinical seizure: FIAS -> FBTCS
- Clinical description: Pointing at the display and saying “I know,,,,,” followed by impaired awareness -> eye deviation to the right, head deviation to the right -> bilateral tonic–clonic movements
- Lateralizing sign: Eye and head deviation to the right
- EEG seizure: Left temporal (Lt T)
- EEG description: Rhythmic theta activity in the left temporal region -> rhythmic delta activity (Lt aT) -> generalization
Seizure 2
- Clinical seizure: FAS -> FIAS
- Clinical description: Anxiety -> behavioral arrest
- Lateralizing sign: None
- EEG seizure: Left anterior temporal (Lt aT)
- EEG description: Rhythmic theta activity, Lt T
Seizure 3
- Clinical seizure: FAS -> FIAS -> FBTCS
- Clinical description: Sensation of discomfort -> impaired awareness -> eye deviation to the right, head deviation to the right -> bilateral tonic–clonic movements
- Lateralizing sign: Eye and head deviation to the right
- EEG seizure: Left temporal (Lt T)
- EEG description: Rhythmic theta activity, Lt T -> rhythmic delta activity, Lt aT -> generalization
Seizure 4
- Clinical seizure: FAS
- Clinical description: Forced blinking
- Lateralizing sign: None
- EEG seizure: Bilateral temporal (Bil T)
- EEG description: Rhythmic theta activity, Bil T
コメント