case_images: PMC11408054_01
case_images: EEG prior to VNS generator replacement, showing high-amplitude bilateral rhythmic delta activity, left hemispheric maximal, at 1.5-2 Hz. Per American Clinical Neurophysiology Standardized Critical Care EEG Terminology, 2021: lateralized, bilateral asymmetric, left hemispheric rhythmic delta activity. Bipolar longitudinal montage, timebase 30 mm/s, HFF 70 Hz, LFF 1 Hz, Notch 60 Hz.
case_images: gr1.jpg
case_images: PMC11408054_01_gr1.jpg
case_images: f0005
case_images: Hz, but remained without clear clinical correlate and were not clearly temporally associated with definitive seizures (Fig. 1). He had replacement of his generator days later; he gradually returned to baseline and was discharged with increase in tiagabine to 16 mg three times daily.
case_images: EEG before VNS turned off (A), after VNS turned off (B) and after VNS turned back on (C). Bipolar longitudinal montage, timebase 30 mm/s, HFF 70 Hz, LFF 1 Hz, Notch 60 Hz. A: Baseline EEG showing intermittent bitemporal slowing, left more than right. B: EEG with high-amplitude bilateral rhythmic delta activity, left hemispheric maximal, at 1.5-2 Hz. Per American Clinical Neurophysiology Standardized Critical Care EEG Terminology, 2021: lateralized, bilateral asymmetric, left hemispheric rhythmic delta activity. C: EEG at similar baseline.
case_images: gr2.jpg
case_images: PMC11408054_01_gr2.jpg
case_images: f0010
case_images: EEG showed diffuse high amplitude rhythmic delta activity, distinctly different from baseline EEG and had not been seen previously post-ictally (Fig. 2).