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Neurology (Expert Forum)
Abnormal EEG and seizures during illness
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Abnormal EEG and seizures during illness
by Christi, Mar 13, 2001 12:00AM
My 4 1/2 year old daughter has suffered from her second seizure in less than a year. In March 2000, she was not feeling well. She was taking med. containing codine. One evening, we were on the floor playing a very familiar game. She became unusually confused and did not know how to play. I assumed the codine was making her "woozy." She stood up and seemed aggitated. She told me to take something from her hand. She had nothing. She walked into the wall. She began to act as if she would vomit. I picked her up. She was rigid and her breathing was shallow. I laid her on the bed and dialed 911. At this time I noticed her staring, fixated on one spot and mild twitching in her hands. She had a fever between 101 - 102. Doctors chalked this up as possible febrile seizure or reaction to codine.
Last month she had an almost identical seizure. Again it happened during illness and the onset of a mild fever (101). The only things absent this time were codine and hallucinations. She had no memory of the seizure, but the memory may have come back to her. Her pediatrician ordered an EEG and the results were abnormal. The earliest appt. we could get with a ped. neurologist is in 4 months! The results of the EEG are as follows: Waking and drowsy state record. Well developed 9/sec. of high voltage seen symmetrically in post. regions during allertness. Low voltage fast forms seen frontally. At times...sudden appearance of mod. to high voltage 4-5/sec. spike wave complexes without preceding spikes. No lateralized slow wave abnormalities, no focal paroxysmal disturbances, no abnormality with photic stimulation. What type of seizure is she having? What does this EEG indicate? What's the long-term prognosis? Do you think things will get better or worse with time? We are so worried.
She also suffers from inconinence and a lazy eye, not the wondering kind. The incontinence is unsuccessfully being treated. She "leaks" all day long. The lazy eye is also not successfully being treated. She wore a patch, but we believe she has regressed. Her lazy eye was visibly smaller at birth to a couple of months old. A vision screening later found she was not using the eye. Could her problems be neurologically related?
Otherwise, she is a normal, beautiful child. She reached all developmental stages on time, and suffered no brain injury that we know of. Any input would be so much appreciated. Four months is too long to wait!
Last month she had an almost identical seizure. Again it happened during illness and the onset of a mild fever (101). The only things absent this time were codine and hallucinations. She had no memory of the seizure, but the memory may have come back to her. Her pediatrician ordered an EEG and the results were abnormal. The earliest appt. we could get with a ped. neurologist is in 4 months! The results of the EEG are as follows: Waking and drowsy state record. Well developed 9/sec. of high voltage seen symmetrically in post. regions during allertness. Low voltage fast forms seen frontally. At times...sudden appearance of mod. to high voltage 4-5/sec. spike wave complexes without preceding spikes. No lateralized slow wave abnormalities, no focal paroxysmal disturbances, no abnormality with photic stimulation. What type of seizure is she having? What does this EEG indicate? What's the long-term prognosis? Do you think things will get better or worse with time? We are so worried.
She also suffers from inconinence and a lazy eye, not the wondering kind. The incontinence is unsuccessfully being treated. She "leaks" all day long. The lazy eye is also not successfully being treated. She wore a patch, but we believe she has regressed. Her lazy eye was visibly smaller at birth to a couple of months old. A vision screening later found she was not using the eye. Could her problems be neurologically related?
Otherwise, she is a normal, beautiful child. She reached all developmental stages on time, and suffered no brain injury that we know of. Any input would be so much appreciated. Four months is too long to wait!
Doctor's Answer
by CCF Neuro[P]-M.D.-RPS, Mar 13, 2001 12:00AM
Dear Chisti:
Sorry to hear about your daughter. It sounds like it might be seizure activity. It is unusual for a youngster to begin to have febrile convulsions beginning at age 4, but not unheard of. Concerning the EEG, I am not sure of what they are calling abnormal, it the sudden onset of theta waves without spikes might very well be hypnagogic activity or transition between awake and sleep or visa vesa. This is normal for children. Since there were no focal features or generalized slowing, the EEG might in fact be normal. At this point, I would watch for fever and treat very vigorously with tylenol to keep her fever down. I might also repeat the EEG with a longer recording time and sleep deprive before. Did they try and hyperventillate and photostimulate her druing the EEG? I probably would also not start medications at this point. But these are my opinions and would defer to your pediatric epileptologist.
Sincerely,
CCF Neuro MD
Sorry to hear about your daughter. It sounds like it might be seizure activity. It is unusual for a youngster to begin to have febrile convulsions beginning at age 4, but not unheard of. Concerning the EEG, I am not sure of what they are calling abnormal, it the sudden onset of theta waves without spikes might very well be hypnagogic activity or transition between awake and sleep or visa vesa. This is normal for children. Since there were no focal features or generalized slowing, the EEG might in fact be normal. At this point, I would watch for fever and treat very vigorously with tylenol to keep her fever down. I might also repeat the EEG with a longer recording time and sleep deprive before. Did they try and hyperventillate and photostimulate her druing the EEG? I probably would also not start medications at this point. But these are my opinions and would defer to your pediatric epileptologist.
Sincerely,
CCF Neuro MD
Thanks for your prayers. When I find out more I let you know.
Toni
brenda
thanks