Abstracts

Rationale: During the EEG recording and interpretation, artifacts can sometimes be challenging. We present a case in which bed related artifacts during EEG recordings were suspicious for an ictal rhythm.Methods: We present a case in which on two different EEG recordings on the same patient, we noted focal rhythmic bed related artifacts.Results: A 32 year old man with history of traumatic brain injury s/p craniotomy for subdural hematoma on the right side and s/p VP shunt on the left many years ago with residual quadriplegia was hospitalized. During his hospitalization, work-up included two video Electroencephalograms done on two separate occasions. He was on alternating low air loss mattress to prevent pressure ulcers. On two different EEG recordings, he was noted to have focal rhythmic waves. During the first episode, his head was turned to the right and showed 10/sec waves on right central and occipital area gradually decreasing to 3/sec waves . During the second episode, he had rhythmic 12-14/sec waves on the left parieto-occipital area gradually decreasing to 2/sec waves. They were suspicious for focal ictal rhythms. However, during the above episodes, his bed was noted to inflate under his head on the video recording. Conclusions: The bed related artifact especially with alternating low air loss mattress can be rhythmic involving focal area, mimicking an ictal rhythm. We believe it is related to movement artifact from the bed. The air loss mattress features high strength air cells, which are vented cyclically by an air blower unit to provide true air loss therapy. This therapy helps keep the patient dry and comfortable. Technologists and Providers need to be aware of the potential for bed related artifact with the air loss mattress. The blower unit device can be turned off prior to the recording to eliminate artifacts.