John Libbey Eurotext

Progression of alternating hemiplegia of childhood-related focal epilepsy to electrical status epilepticus in sleep with reversible encephalopathy Volume 24, issue 1, February 2022

Figure 1

EEG at age four years old. (A) Awake EEG with right temporal sharp waves, best observed at T6. (B) Awake baseline with predominantly right fronto-central spike-and-slow-wave discharge. (C) Normal sleep with occasional right frontal, F8, sharp wave activity. (D) Left-posterior-onset focal seizure.

Figure 2

EEG at age 10.5 years. (A) Awake baseline shows diffusely slow ∼5-Hz background with generalized 4-Hz spike-and-slow-wave discharges occurring in brief bursts somewhat better formed on the right. (B) ESES Pattern 1: near-continuous generalized spike-and-slow-wave discharges in sleep. (C) ESES Pattern 2: near-continuous bilateral parasagittal spikes and sharp-wave discharges (blue lines).

Figure 3

Brain MRI and MRI spectroscopy at age five years (left panels) and age 10 years (right panels). (A, B) Brain MRI T2 sequence axial view at midline: normal at age five years (A) and interval cerebral and cerebellar atrophy at age 10 years (B). (C-F) MRI spectroscopy: normal at age five years (C, E) and interval depressed NAA peaks at age 10 years (D, F).