PMC8777096_01
Interictal electroencephalography (EEG) shows spiking activity and slow sharp waves located over the temporal regions bilaterally.
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Interictal EEG showed sharp waves bilaterally located over the temporal regions (Figure 1).
(A) Ictal asystole. On ictal EEG recording note the diffuse electrodecrement followed by buildup of rhythmic 4-6 Hz sharp activity more evident in the left temporal regions. On ECG, there is a progressive slowing of heart followed by asystole of 8 s. The dashed arrow indicates seizure onset, while the full arrow indicates the artifact due to the patient's fall from standing position. (B) Coronary angiography shows sub-occlusive stenotic traits (circles) of the left anterior descending coronary. (C) Ictal EEG after angioplasty shows a similar pattern with no modification of hearth rate on ECG channel. (D) Coronary angiography after angioplasty shows normal flow of the left anterior descending coronary.
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The ictal EEG revealed a diffuse electrodecrement followed by buildup of rhythmic 4-6 Hz sharp activity more evident in the left temporal region (Figure 2). After seizure onset, the ECG always showed sinus bradycardia, followed on one occasion by eight-second sinus arrest that was associated with the patient's fall from the standing position (Figure 2). Coronary angiogram showed sub-occlusive stenosis of the left anterior descending artery (Figure 2).