JLE

Epileptic Disorders

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A multimodal diagnostic approach for lateralised rhythmic delta activity in the ictal-interictal continuum Volume 22, issue 3, June 2020

Figure 1

(A) Computed tomography-perfusion on the left temporo-parietal areas (white arrows) showing a relative increase in cerebral blood volume (CBV) and cerebral blood flood (CBF) with minimal values for mean transit time (MTT) and time to peak (TTP), suggesting hyperperfusion. (B ,C) EEG recorded one hour after tCTP (sensitivity: 7 μV/mm). (B) Lateralised rhythmic delta activity (LRDA) on the left hemisphere with a prevalence in the temporal areas. (C) On the same recording, LRDA occasionally showed a sharp aspect (bipolar longitudinal montage [left] and average reference montage [right] of the same trace).

Figure 2

(A) EEG performed 15 hours after the introduction of antiepileptic treatment showing the disappearance of left lateralised rhythmic delta activity (LRDA) and persistence of mild left hemispheric slowing (asymmetry of the posterior rhythm and some intermittent delta waves). (B) EEG at discharge showing no significant visible asymmetry, but only mild diffuse slowing which was already observed months before.