Picture 1. Wakefulness interictal EEG showing occasional multifocal paroxysmal bursts of high voltage spike-wave complexes.
Stabilization of seizures was not achieved, there were also focal seizures. Therefore, a second AED, lamotrigine, was added to the treatment. Regarding the allergic reaction due to lamotrigine, it was discontinued, and the treatment included acetazolamide. During this period the EEG findings in wakefulness and post-hyperventilation, showed occasional multifocal mainly bitemporal bursts of spike-and-waves, while on sleep EEG revealed occasional multifocal left-sided frontotemporal and parietooccipital spike-and-waves bursts (see pictures 2, 3, 4).