Epilepsy

Report:

Sinus rhythm

Movement artefact consistent with tremor or fitting

Comment:

The rapid regular rhythm of both episodes is beyond the power of most percussion physiotherapists; at any rate (or, better, at this rate!), the patient was fitting. Vibration physiotherapy, however, cannot be excluded, or even epilepsia partialis continua in the physiotherapist! The appearance of fits is very variable, depending on the electrode placement and the clinical expression of the fit.

The treatment of choice is usually clonazepam, also used for the more prognostically sinister myoclonus, but its main benefit (in the long run) may be to restore peace and quiet to the ICU.

More is shown below (Fig 153a).

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