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The relationship between dreams and epilepsy is illustrated by two patients whose awake epileptic seizures and recurrent dreams during night sleep had similar content. In both of our cases the EEG showed right anterior temporal spike discharge, suggesting a role for the temporal lobe in the association between dreams and seizures.

SUMMARY -We describe an atypical clinical and electroencephalographic (EEG) pattern observed during the course of subacute sclerosing panencephalitis in a 14 year-old boy. In this patient with a two weeks history of partial complex seizures, the atypical EEG pattern was characterized by an initial left temporal focus which evolved to periodic lateralized epileptiform discharges (PLEDs) and, only during the 3 rd and 4 th weeks the typical bilateral and generalized periodic complexes appeared.KEY WORDS: subacute sclerosing panencephalitis, EEG, periodic complexes, partial complex seizure.Since the early reports of Radermecker (1949) 12 and Cobb and Hill (1950) 2 , the great diagnostic value of electroencephalographic (EEG) findings in subacute sclerosing panencephalitis (SSPE) has been outlined by numerous workers. As is well known, the characteristic EEG pattern consists of high-voltage and polymorphic periodic complexes, recurring at long intervals, grossly widespread throughout both hemispheres 3 that are often associated with motor spasms.In the case reported here, the patient presented partial complex seizures and an atypical EEG finding, making the diagnosis more difficult. We are aware of only one study of SSPE with partial complex seizures 9 . REPORT OF CASEHJ, a 14-year-old boy had partial complex seizures two weeks before being seen at the Escola Paulista de Medicina, that were characterized by loss of consciousness, staring, verbal and gestual automatisms, several times per day. Also, cognitive and intellectual deterioration had developed. A diagnosis of partial complex seizures and behavioural disturbance were made. Despite treatment with anticonvulsants (carbamazepine) the * Head of the EEG Sector, Escola Paulista de Medicina (EPM); **Junior Doctor of the EEG Sector; ***Resident in Neurology; ****Full Professor and Head of the Discipline of Neurology, EPM. Aceite: 2-janeiro-1995.Dr. Délrio Façanha da Silva -Disciplina de Neurologia, Setor de Eletrencefalografia, Escola Paulista de MedicinaPadrão clínico e eletrencefalográfico atípico em um paciente com panencefalite esclerosante subaguda RESUMO -Descrevemos o quadro clínico e eletrencefalográfico atípicos observados durante a evolução de panencefalite esclerosante subaguda, em um menino de 14 anos. Neste paciente, com história de crises parciais complexas há duas semanas, o padrão eletrencefalográfico atípico foi caracterizado por foco temporal esquerdo que evoluiu para "periodic lateralized epileptiform discharges" (PLEDs), somente durante a 3 a e 4 a semanas surgindo os clássicos complexos periódicos difusos. PALAVRAS-CHAVE: panencefalite esclerosante subaguda, EEG, complexos periódicos, crise parcial complexa.

SUMMARY -The subclinical rhythmic electrographic discharge in adults (SREDA) has been rarely reported. We describe the case of a 71 year-old man with transient ischemic attack, whose EEG showed an atypical evolution of this uncommon pattern. The computed tomography scan and cerebrospinal fluid were normal. We are not aware of any other report in the literature with this atypical evolution of SREDA.KEY WORDS: subclinical rhythmic electrographic discharge in adults (SREDA), EEG. Descarga eletrográfica rítmica subclínica do adulto: uma evolução atípicaRESUMO -A descarga eletrográfica rítmica subclínica do adulto tem sido raramente referida na literatura. Relatamos o caso de um homem de 71 anos com ataque isquêmico transitório, cujo EEG mostrou evolução atípica deste padrão incomum. A tomografia computadorizada de crânio e o liquido cefalorraquidiano foram normais. Na literatura por nós pesquisada, não achamos outra publicação com evolução atípica do SREDA. PALAVRAS-CHAVE: descarga eletrográfica rítmica subclínica do adulto (DERSA) (SREDA), EEG.The subclinical rhythmic electrographic discharge in adults (SREDA) 10 was first described as "décharges paroxystiques du carrefour" by Naquet et al. (1961,1965) 6,7 and it is considered a benign EEG pattern of uncertain significance 11 . It may closely resemble an EEG seizure pattern and it is an unusual EEG finding 5 -9 -w with an incidence of 0.02-0.045% 2 .Our aim in this paper is to report a case of this rare situation on EEG. CASE REPORTJTN, a 71-year-old man with a story of hypertension and ischemic attack was referred to the neurological emergency room. At the first neurologic examination he was conscient, disphasic and without other neurological signs. The disphasy (Wernicke's type) lasted 20h and then disappeared. ECG, echocardiography, CSF and CT scan were normal. His neurologic status remained stable, and at hospital day 2 an EEG was recorded.The first EEG (EEG1) was performed 24 h after the onset of symptoms and lasted 45 min. The patient was resting quietly with eyes closed and exposed to minimal background noise. EEG tracings were obtained on

SUMMARY -We studied four children with diagnosis of absence seizures (generalized primary epilepsy), and with a generalized delta activity on the EEG during clinical attacks provoked by hyperventilation. The lack of ictal generalized spike-and-wave discharges with a frequency of 3 Hz in our patients, makes this an atypical pattern. All children had complete control of their seizures and disappearance of the EEG changes with valproate. We concluded that generalized delta activity observed on EEG during the hyperventilation in children should not always be considered as a normal finding for age, since it could be an ictal event of an absence seizure.KEY WORDS: epilepsy, absence seizures, EEG, hyperventilation, delta activity. Padrão atípico no EEG de crianças com crises de ausênciaRESUMO -Estudamos quatro crianças com o diagnóstico de crises de ausência (epilepsia generalizada primária) e com atividade delta generalizada no EEG, durante crises provocadas pela hiperpnéia. A ausência de descargas generalizadas por complexos ponta-onda a 3 Hz, durante as crises de nossos pacientes, é achado incomum. Todas as crianças tiveram completo controle de suas crises com o valproato, assim como o desaparecimento das alterações no EEG. Concluimos que a atividade delta generalizada observada no EEG de crianças durante a hiperpnéia nem sempre deve ser vista como achado normal, podendo ser um evento crítico da crise generalizada ausência. PALAVRAS-CHAVE: epilepsia, crises de ausência, EEG, hiperventilação, atividade delta.Childhood absence seizures is a type of generalized epilepsy, and includes characteristic clinical and EEG manifestations. It is characterized by onset of seizures between the age of 3 and 12 years and a peak at 6-7 years, absence seizures and an EEG finding of generalized spike-and-wave complexes with a typical frequency of 3 Hz. It is well known that during hyperventilation in children, delta activity is frequently seen, and is considered reflexion of a normal development finding 2,5 . Lee and Kirby (1988) 7 first reported generalized high amplitude rhythmic delta activity during hyperventilation accompanied by clinical manifestation of staring spells with unresponsiveness.Our aim in this paper is to describe four children, 6-8 year old, who presented generalized delta activity on EEG during hyperventilation and that were accompanied by clinical seizures. REPORT OF CASES• Case 1: CCOS, a 7-year-old girl had onset of absence seizures four months earlier. Pregnancy and delivery were normal, as was the child's early development. Physical and neurological examinations were normal, as well as computed tomography (CT) scan. Their seizures lasts no longer than a few seconds, occurred up to 4 per day, with no postictal changes. During the absences seizures, there was a loss of awareness and responsiveness

SUMMARY -We describe the case of a 15-year-old boy who had the diagnosis of benign partial epilepsy of childhood with centrotemporal spike. During the EEG a subclinical electrographic seizure was recorded. The discharges were clearly electropositive in T4 with positive phase reversal between derivations F8-T4 and T4-T6. The whole episode lasted less than one minute (45 sec). The interictal right medio-temporal spikes reemerged after 60 sec and were electronegative in the same location after the end of the electrographic seizures. The mechanisms underlying this uncommon pattern on EEG is not well stablished.KEY WORDS: EEG, dipole reversal, benign partial epilepsy of childhood with centrotemporal spike. Reversão de dipolo: um achado crítico em um paciente com epilepsia parcial benigna da infância com ponta centrotemporalRESUMO -Relatamos o caso de um menino de 15 anos com o diagnóstico de epilepsia parcial benigna da infância com ponta centrotemporal. Durante o EEG uma crise eletrográfica subclínica foi gravada. As descargas estavam eletropositivas em T4 com reversão de fase positiva entre as derivações F8-T4 e T4-T6. O episódio durou menos que um minuto (45 seg). As espículas inter-ictais, na região temporal média direita, reapareceram 60 seg após e estavam eletronegativas na mesma região depois do término da crise eletrográfica. O mecanismo subjacente a este padrão incomum no EEG não está bem estabelecido. PALAVRAS-CHAVE: EEG, reversão de dipolo, epilepsia parcial benigna da infância com ponta centrotemporal.During the last years an epileptic syndrome, associated with rolandic spikes, was recognized and it is known as benign partial epilepsy of childhood with centro-temporal spikes (BECT) 7 , also termed benign rolandic epilepsy 17 . There are few reports in the literature during the ictal phase 5,6,12,15 and only one paper during a diurnal seizure 13 . We are aware of four publications of BECT during a "status epilepticus" 3,5,916 and of one case with ictal dipole reversal 12 .We report an ictal feature on the EEG with dipole reversal in BECT.

SUMMARY -We report four children with epilepsy with "continuous spike-waves during slow wave sleep" (CSWSS). The main clinical features were partial motor seizures, mental retardation and motor deficit. The EEG findings were characterized by nearly continuous (>85%) diffuse slow spike and wave activity in two patients, and localized to one hemisphere in two other cases during non-REM sleep. The treatment was effective in improving the clinical seizures, but not the EEG pattern. We believe that this epileptic syndrome has been overlooked and routine sleep EEG studies on epileptic children may disclose more cases of CSWSS.KEY WORDS: epilepsy with continuous spike-waves during slow wave sleep, EEG, sleep. Epilepsia com ponta-onda contínua do sono lento: estudo clínico e eletrencefalográficoRESUMO -Relatamos quatro crianças epilépticas com "ponta-onda contínua durante o sono lento" (POCSL). Os principais achados clínicos foram crises parciais motoras,retardo mental e déficit motor. Os EEG se caracterizaram por complexos ponta-onda quase contínuos (>85%) difusos em dois pacientes e localizados em um hemisfério nos outros dois casos. O tratamento foi eficaz no controle das crises, mas não em relação ao EEG. Achamos que este quadro tem sido pouco relatado e estudos do sono em crianças epilépticas podem revelar mais casos de POCSL. PALAVRAS-CHAVE: epilepsia com ponta-onda contínua do sono lento, EEG, sono. We describe two patients with "partial electrical status epilepticus during sleep" and two with the generalized form. The CSWSS was first described by

SUMMARY -We studied two children with a history of headache and a normal physical and neurological examination whose EEG showed an electroencephalographic pattern recently published, the N-shape potential associated with the 14 Hz positive spikes. This graphoelement was observed only during the asleep state.