Clinical Intake — Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset

A 54-year-old woman presents with a 14-month history of recurrent seizure-like episodes characterized by staring spells, left-hand automatisms, and post-ictal confusion lasting 5 to 10 minutes. Outpatient EEG in late 2025 demonstrated left temporal intermittent rhythmic delta activity without definitive ictal capture. She has been maintained on levetiracetam, titrated to 1000 mg twice daily, with persistent breakthrough events occurring 2 to 3 times per month despite dose optimization. Dr. Krishnamurthy recommends further inpatient neurophysiologic evaluation for definitive seizure type classification and presurgical assessment.