Picture 4. Post-hyperventilation EEG showing occasional
multifocal mainly bitemporal bursts of spike-and-waves.
A period of seizure freedom occurred from age 9 to 11 occurred after
commencing acetazolamide. There was no history of absence seizures or
myoclonic seizures, meanwhile, episodes of staring spells with no EEG
changes were noted. The follow-up wakefulness EEG findings showed
stabilization, meaning a regular brain activity of alpha rhythm with
isolated right-sided spike-and-wave bursts.
Thereafter, followed a period of frequent twice-a-week generalized
tonic-clonic seizures and one focal epileptic seizure. Levetiracetam was
included in the antiepileptic treatment. Repeat wakefulness EEG findings
showed focal bursts of left-sided parieto-occipital and temporal
spike-wave discharges. (see picture 5). Epilepsy protocol
magnetic resonance imaging of the brain was normal.