case_images: PMC10086123_01
case_images: Imaging examinations of the patient. Brain magnetic resonance imaging (MRI) showed no obvious abnormality at the age of 6.5 months (A). T1-weighted and T2-weighted images were consistent. Electroencephalogram (EEG) results before and after antiepileptic medications (B-D). (B) A burst-inhibition pattern was observed before any medication at 2 months. (C) With a treatment of oral adrenocorticotropic hormone (ACTH), topiramate, and valproic acid, the intensity of the burst period was significantly weakened, but the burst-inhibition pattern was still obvious, and their durations remained relatively long. In addition, a small amount of bilateral discharge and an extremely asymmetric background were observed. (D) After treatment of prednisone, topiramate, levetiracetam, and midazolam, there were very few burst periods and reduced inhibition periods, with significantly shorter durations at 3 months. A small amount of 4-6c/stheta activity was visible and distributed. Distinguishable focal discharges in the background, apparent asymmetry, and a tendency for a high degree of arrhythmia were also observed.
case_images: fneur-14-1146875-g0001.jpg
case_images: PMC10086123_01_fneur-14-1146875-g0001.jpg
case_images: F1
case_images: At 2 months of age, the patient was admitted to the hospital and a clinical diagnosis of OS was made based on the burst-suppression EEG result (Figure 1B). With the administration of adrenocorticotropic hormone (ACTH), topiramate, and valproic acid, the intensity of the burst period was weakened, but the burst-inhibition pattern was still obvious, and their durations remained relatively long by EEG (Figure 1C). At 3 months of age, with a treatment of prednisone, topiramate, levetiracetam, and midazolam, EEG showed very few burst periods, reduced inhibition periods, and significantly shorter durations (Figure 1D). Brain magnetic resonance imaging (MRI) showed no obvious abnormality at the age of 6.5 months (Figure 1A).