A Rare Case of Contralateral Onset of Seizures and SIRPIDs (Stimulus Induced Rhythmic, Periodic or Ictal Discharges)

SIRPIDs (Stimulus Induced rhythmic, periodic, or ictal discharges) represent a relatively newer addition to the terminology of electroencephalography (EEG) monitoring. They are meant to represent findings that may have epileptogenic potential and are repeatedly produced in response to various stimuli. SIRPIDs have variable association with various pathologies and the concurrent occurrence of seizures, which adds to the difficulty in quantifying their epileptogenic potential and offering consistent treatment guidelines. We describe a rare case of a patient that presented with a left hemispheric subdural hematoma and developed left hemispheric onset seizures and right hemispheric onset SIRPIDs in response to physical stimulation. Our case aims to highlight the diverse nature of SIRPIDs and showcase unusual presentations of SIRPIDs that make recognizing this unusual condition more challenging and contribute to a better understanding of these weird EEG findings.