Figure 1.

Electroencephalography (EEG): (a) EEG seizure arising from the right hemisphere, maximum temporo-parietal region. Seizures were seen occurring at a rate of 6–10 per hour lasting up to 3 minutes in duration without clinical signs. Seizures were frequent despite levetiracetam, lacosamide, phenobarbital, valproic acid, phenytoin, ketamine, midazolam, and pentobarbital. Sharply contoured generalized periodic discharges were seen interictally (b). Two hours after perampanel load (32 mg), the EEG transitioned to background suppression, and no further seizures were observed for the next 72 hours (c). Bitemporal montage, sens 7 uV, Lf 1.6 Hz, HF 70 Hz, 15 s epoch.