case_images: PMC10937297_01
case_images: Video-eeg and brain imaging tests at baseline and at follow-up (five-months from the onset). A) EEG at baseline: it showed non-specific bilateral centrotemporal theta activity. B) Brain MRI (from left to right FLAIR and T1 sequence are displayed) at baseline: it showed chronic vascular encephalopathy; no hummingbird sign in sagittal T1-sequence. C) Video-EEG at follow-up: it evidences non-specific diffused theta and delta patterns with a typical repetitive pattern of bilateral synchronous quasi-periodic triphasic waves localized on the posterior regions of the brain. D) Brain MRI at follow-up (from left to right DWI, FLAIR and T1 sequences are displayed) demonstrating DWI hyperintensity (bright areas) in the caudate and putamen (hockey-racket sign) and the cortical ribbon. Abnormal hyperintensity is also present on the FLAIR sequence. No hummingbird sign in sagittal T1-sequence. Abbreviations:EEG, electroencephalogram; MRI, magnetic resonance imaging.
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case_images: Brain magnetic resonance imaging (MRI) showed chronic vascular encephalopathy (Fig. 1B). The electroencephalogram (EEG), performed as a routine investigation in cases of repeated falls of uncertain origin in our clinical setting, showed non-specific bilateral centrotemporal theta activity (Fig. 1A). At this time, a video-EEG showed the presence of non-specific diffuse theta and delta patterns with a typical repetitive pattern of bilateral synchronous quasi-periodic triphasic waves localized on the posterior regions of the brain (Fig. 1C). Brain MRI also suggested finding typical of CJD, demonstrating DWI hyperintensity in the caudate and putamen (hockey-racket sign) and a ribbon-like signal in frontal, temporal, and insular regions (Fig. 1D).