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Case Reports
. 2014 Jul;56(7):695-8.
doi: 10.1111/dmcn.12365. Epub 2014 Jan 11.

Global suppression of electrocortical activity in unilateral perinatal thalamic stroke

Liudmila Kharoshankaya  1 , Peter M Filan, Conor O Bogue, Deirdre M Murray, Geraldine B Boylan
Affiliations
Free PMC article
Case Reports

Global suppression of electrocortical activity in unilateral perinatal thalamic stroke

Liudmila Kharoshankaya et al. Dev Med Child Neurol. 2014 Jul.
Free PMC article

Abstract

We present an unusual case of persistent generalized electroencephalography (EEG) suppression and right-sided clonic seizures in a male infant born at 40(+2) weeks' gestation, birthweight 3240g, with an isolated unilateral thalamic stroke. The EEG at 13 hours after birth showed a generalized very low amplitude background pattern, which progressed to frequent electrographic seizures over the left hemisphere. The interictal background EEG pattern remained grossly abnormal over the next 48 hours, showing very low background amplitudes (<10μV). Magnetic resonance imaging revealed an isolated acute left-sided thalamic infarction. This is the first description of severe global EEG suppression caused by an isolated unilateral thalamic stroke and supports the role of the thalamus as the control centre for cortical electrical activity.

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Figures

Figure 1
Figure 1
Dual-channel amplitude-integrated electroencepaholgrapy (EEG) and EEG in a male term infant with left-sided thalamic stroke. (a) The background EEG from approximately 14 hours after delivery showed severe global suppression with a low-voltage burst suppression pattern (<10μV). No state cycling was evident. This continued for up to 48 hours, after which a gradual increase in voltage was seen to approximately 25μV. (b) Electrographic seizures show a clear focus over the left hemisphere with some right sided spread.
Figure 2
Figure 2
Magnetic resonance imaging on day two. Axial diffusion-weighted imaging demonstrating restricted diffusion in the left thalamus and left internal capsule.
See this image and copyright information in PMC

References

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