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. 2014 Sep 1;1:11. doi: 10.1186/2053-8871-1-11

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© Sarrigiannis et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Myoclonic status epilepticus (case 7). (A) Routine EEG while the patient was obtunded and had frequent irregular left upper and lower limb myoclonic twitches. The surface EMG electrodes in the left thigh were recording from the quads (upper trace) and the biceps femoris. In the forearm, surface electrodes were recording from the extensor digitorum communis (upper trace) and the finger flexors. EEG tracing shows, about 1 Hz, periodic lateralized epileptiform discharges in the right posterior quadrant. Note that these are not time matched to the myoclonic jerks from the left arm and leg. (B) Jerk-locked back averaging from the left quads (80 sweeps). There is a time locked negative sharp wave preceding the onset of the averaged, rectified EMG data by about 25 ms. These recordings were performed in the ICU at a sampling rate of 500 Hz.