PMC4307880_01
Postcontrast FLAIR image from an MRI done on 07/8/2013, demonstrating bilateral hippocampal hyperintensity bilaterally, with enhancement after contrast administration.
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On repeat brain MRI imaging done two days later on 7/8/2013, she had hippocampal hyperintensity bilaterally on FLAIR images and enhancement after gadolinium contrast administration (Fig. 1).
Early EEG demonstrates frontally maximal high-voltage beta activity superimposed on frontally maximal delta waves consistent with 'extreme delta brush.' There is also phase reversal on this bipolar montage over the right temporal lobe. This continuous EEG was captured on 7/07/2013 at 12:00 at a sensitivity of 5 muV/mm.
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Additionally, her continuous EEG monitoring within the first few days began to demonstrate frontally maximal high-voltage beta activity superimposed on frontally maximal delta waves (Fig. 2).
Late EEG demonstrates frontally maximal high-voltage beta activity superimposed on frontally maximal delta waves consistent with 'extreme delta brush.' This continuous EEG was captured on 10/21/2013 at 00:03 at a sensitivity of 5 muV/mm.
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Additionally, follow-up EEG performed on 10/31/2013, 121 days after presentation, continued to show pronounced extreme delta brush (Fig. 3).