PMC3985367_01
(a) T1-weighted magnetic resonance image showing hypointensities in bilateral parieto-occipital regions, left more than right, (b) T2-weighted and, (c) FLAIR images (FLAIR: Fluid-attenuated inversion recovery) showing hyperintensities in the same region, (d) FLAIR images showing bilateral frontal and parietal hyperintensities, (e) Diffusion weighted and, (f) Apparent diffusion coefficient images showing no restriction suggestive of vasogenic edema
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F1
Magnetic resonance imaging (MRI) of the brain [Figure 1] showed T1 hypointense, T2, and FLAIR (FLAIR: Fluid-attenuated inversion recovery) hyperintense lesions in bilateral parieto-occipital (left > right) and frontal regions without contrast enhancement.
Initial electroencephalogram (EEG) of the patient on admission showed periodic short-interval (0.75 Hz) sharp waves [periodic lateralized epileptiform discharges (PLEDs)] of 100-150 muV amplitude over the right occipital region with medium-amplitude delta and slow theta activity, which was generalized. There were small-amplitude sharp wave discharges of ~ 50 muV amplitude (arrow) over the after-coming slow waves giving a PLEDs-plus morphology
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F2
Electroencephalogram (EEG) [Figure 2] showed medium amplitude 3-4 Hz delta and slow theta activity which was generalizedalong with periodic short-interval (0.75 Hz) sharp waves of 100-150 muV amplitude over the right occipital region.
Second electroencephalogram (EEG) of the patient after giving valproate showed disappearance of periodic lateralized epileptiform discharges (PLEDs). Intermittent photic stimulation at low frequency showed grade III photoparoxysmal response (PPR) from bilateral occipital regions (right > left), although the background activity, which consisted of generalized medium-amplitude delta and slow theta activity
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F3
But intermittent photic stimulation at low frequency showed grade III photoparoxysmal response (PPR) from bilateral occipital regions (right > left), although the background activity remained the same [Figure 3].