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EEG tracings from Case 1 demonstrate an electrographic change in seizures in the same patient.. (A) Bipolar montage from EEG at age 3 shows bursts of spike and wave and polyspike and wave complexes, consistent with EMAS. His seizures went into remission with valproic acid, and valproic acid stopped. At the age of 9 he developed new absence seizures, with EEG showing shifting asymmetry of 3 Hz spike and wave complexes only induced by hyperventilation (B).
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EEG revealed polyspike and wave bursts with a normal background suggestive of EMAS (Fig. 1A). Hyperventilation in the clinic induced a classic absence seizure and an EEG revealed 3-Hz spike and wave discharges, shifting at times from left to right maximal, only with hyperventilation (Fig. 1B).
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