ABSTRACT

Occipital intermittent rhythmic delta activity (OIRDA) is considered as an electroencephalography (EEG) pattern which is usually seen in children but does not always have pathological significance. The physical examination of a 70-year-old patient who was admitted with complaints of hallucination, headache and falling episodes, revealed just a deficiency of vigilance and concentration. Magnetic resonance imaging of the patient revealed generalized chronic ischemic changes, cerebral atrophy and leukoaraiosis especially prominent in the posterior regions. There was OIRDA presence in the occipital regions in routine EEG examination. Since the patient’s symptoms continued despite phenytoin, oxcarbamazepine and topiramate, we replaced topiramate with levetiracetam. Patient’s visual illusions and falling episodes diminished following treatment, and also OIRDA highly disappeared in the EEG.

Keywords: Epilepsy, migraine, occipital intermittent rhythmic delta activity