Figure 2
EEG (AP bipolar montage; LFF: 1 Hz; HFF: 70 Hz; sensitivity: 10 μV) epochs showing interictal (upper panel) and ictal (middle and lower panel) findings. Interictal epileptiform discharges can be seen asynchronously in the left frontal, left anterior temporal, right frontal, and right anterior temporal head regions, as well as diffusely bilaterally. Low-amplitude paroxysmal fast activity can also be seen in the right posterior temporal head region. Ictal onset (middle panel; arrows) was characterized by a diffuse sharp wave with central/parietal amplitude emphasis, followed by diffuse attenuation and superimposed low-amplitude fast activity, followed by 2-3 Hz sharply contoured polymorphic delta activity in a similar distribution. The seizure ends abruptly after 22 seconds (lower panel; arrow) with return of the interictal pattern. Clinically, the patient opened his eyes, had tonic extension of all four extremities (predominantly the legs), and a few clonic jerks of the arms towards the end of the seizure.