Eeg Seizure Video Patient

One patient with a clinical picture of mania was treated with haloperidol and lithium until an EEG indicated a diagnosis of photoconvulsive epilepsy. Subsequent treatment with carbamazepine led to long-term remission of her symptoms (116). A 33-year-old woman presented with disinhibited speech, hyperactiv-ity, generalized amnesia, auditory hallucinations (God was talking to her), visual hallucinations, grandiosity, and complete insomnia 1 week after a skiing accident in which she had lost consciousness. The initial EEG showed bursts of spike waves over the left frontotem-poral region. A computed tomography (CT) scan showed a right frontal subdural hematoma. The EEG normalized after treatment with phenobarbital, but symptoms of mania persisted, despite chlorpromazine, until her third session of electroconvulsive therapy (ECT). She completed six sessions of ECT and was free of symptoms for 3 years. She had two additional episodes of mania and complex partial status, each time with a similar course, each time after 3 years of well being (117).

A study of twenty-seven patients with complex partial seizures, using intracranial electrodes, found that lateral temporal lobe seizures were more likely to lead to an initial facial expression of happiness or sadness at seizure onset. These lateral temporal lobe seizures were more likely to have psychic or sensory features (118). Mesial temporal lobe seizures were more likely to lead to an expression of disgust and occur with autonomic symptoms.

Bilateral Seizures
This patient with catatonic seizures is shown with his left arm raised and immobile (reproduced from video). The EEG shows bilateral posterior and left temporoparietal rhythmic activity. LFF = 0.1 Hz; HFF = 30 Hz.

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