PMC6849077_01
POLG disease visualized through EEG examples. Panel A) EEG sample from the patient from an early clinical recording, showing almost continuous 2 Hz polyspike-and-slow waves mainly over the right parieto-occipital region. Panel B) Continuous EEG recording from the tDCS experiment showing channels (from top to bottom) C4, C3, P3, O1 and EMG1 and EMG2 being the right hand and left trapezius, respectively.
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EEG showed ongoing epileptiform discharges over the right occipital region (Fig. 1A) that later involved most of the right cerebral hemisphere, and because of persisting uncontrolled epileptic activity she was loaded with phosphenytoin before using anesthesia with propofol and ketamine at relevant clinical dosages to provide effective serum levels, as well as lowering her core body temperature to 33  C in accordance with the Norwegian treatment guidelines. At the point where tDCS treatment was instituted, the patient had a multifocal seizures with multiple semiologies (Fig. 1A and B) including a multifocal, asynchronous myoclonus, that was dominant and most debilitating in the right hand.