PMC6327909_01
Trend EEG revealed generalized 5-6 Hz theta with admixed 2-3 Hz delta frequency slowing. There was evidence of multifocal, independently occurring, sharp waves in the bilateral cerebral hemispheres occurring most prominently with stimulation. With stimulation, discharges occur with 1-2 Hz periodicity. Additionally, frequent generalized triphasic waves were seen. Triphasic waves were seen in addition to generalized slowing of the background activity. These collective findings in the setting of underlying diffuse cerebral dysfunction suggested the potential for seizures to arise.
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An EEG was ordered which showed generalized triphasic waves and independent multifocal sharp waves, concerning for nonconvulsive status epilepticus (Fig. 1).
Trend EEG shows dramatic improvement after levetiracetam administration.
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She continued to receive maintenance levetiracetam doses and her mental status continued to improve (Fig. 2).
Representative images of patient's brain MRI. There was no evidence of hemorrhage, infarct, or other acute intracranial abnormalities.
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Brain magnetic resonance imaging (MRI) was unremarkable (Fig. 3).