Figure 1. Representative EEGs.

(A)   The spot EEG showed no epileptiform discharges when the patient performed hyperventilation, verbally primed as a suggestive seizure maneuver here (green boxes). Meanwhile, he reported a “current” traveling upward in his right leg that was seen shaking.   (B)   During the continuous EEG, the patient had several seizures with right legs jerking, rightward gaze, right arm extended, left arm postured into a figure of four, and soon after GTC. The seizures, on average, lasted for about 1 minute. This EEG demonstrated emerging rhythmic muscle artifact as he went through the GTC phase. Of note, there seemed to be semi-rhythmic 2-3 Hz discharges from bilateral parasagittal and central chains preceding the muscle artifact.

GTCs: generalized tonic-clonic seizures