The Continuous Rhythmic Mid-Temporal Discharge

Abstract

This case report is of a 15-year-old male who was sent for an EEG because of possible staring spells and a learning disability. At times written examinations in school were successfully completed and at other times the patient would write only his name. In two EEGs 1 month apart during hyperventilation, Rhythmic Mid-Temporal Discharges (RMTD) were activated and appeared continuously for 84 minutes and in the second instance for 140 minutes. No maneuvers could modify the pattern and no clinical changes were reported by the patient. Discussion includes another similar case recently published and the need to test such patients in some way to see the subtle clinical changes that likely do occur. One compromise for the name of this pattern might be Rhythmic Mid-Temporal Epileptiform Activity (RMTEA), avoiding the term discharge, which implies a seizure state that has not yet been established.