JLE

Epileptic Disorders

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Pointed rhythmic theta waves: a unique EEG pattern in KCNQ2-related neonatal epileptic encephalopathy Volume 19, issue 3, September 2017

Figure 1

MRI on the third day of life demonstrating bilateral signal abnormality on T1-weighted imaging sequences in the basal ganglia, mainly in the globi pallidi and extending into the cerebral peduncles. There was no signal abnormality on T2-weighted imaging and no restricted diffusion.

Figure 2

Composite of representative EEG tracings. (A) Background EEG abnormalities on the fifth day of life. EEG trace demonstrates a burst-suppression pattern, at times with polyspikes and sharp waves for bursts of five seconds and interburst intervals of one to three seconds (speed: 1.0 mm/s). (B) Ictal EEG displaying seizure onset with fast low-amplitude spikes arising from right centro-temporal areas on Day 26. Lidocaine infusion was started on the same day, following increased seizure burden over the preceding 24 hours (speed: 10 mm/s). (C) Postictal EEG demonstrating 4 to 5-Hz rhythmic theta waves of lambdoid morphology over the right posterior quadrant immediately after cessation of electrographic seizure activity on the sixth day of life (speed: 30 mm/s).