Footnotes

• Contributors AA: summarised the patient’s presentation and investigation results. Proposed initial draft manuscript and performed initial literature search. AG: significant contributions to discussion section on electrophysiological features of extreme delta brushes and brief ictal rhythmic discharges (BIRDS). RJ: significant contributions to discussion section on electrophysiological features of extreme delta brushes and BIRDS. GM: revised the work critically and redrafted aspects. SJ: revised the work critically and redrafted aspects. All authors agree to be accountable for all aspects of the published case report.

• Competing interests None declared.

• Patient consent Obtained.

• Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Nick Kane, Bristol, UK.