ADD and EEGs

    
      Re: Re: Re: ADD and EEGs
    


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Posted by CCF Neuro[P] MD, RPS on October 26, 1998 at 12:45:34:

In Reply to: Re: Re: ADD and EEGs posted by Carrie James on October 25, 1998 at 13:22:15:

: Dear CCF Neuro:Pediatrics MD, RPS:
  GO BRUINS!  My husband, Garry James, went there from 1970 - 74.
  I would guess that is way before your time?  Our son, the subject
  of these correspondence, has big plans to go there as well.  
  THANK YOU SO MUCH FOR THE VERY HELPFUL RESPONSE TO MY QUESTIONS!!!
  Yes, he does show some signs of hyperacitivity.
  No, he did not (to our knowledge) have any seizure activity associated
  with his head injury.  He did vomit and I am pretty sure the hospital
  said he had a slight concussion.
  We don't know if he lost consciousness because he was on the playground
  at school.  If he did it would have been for a brief time.
  Regarding any other neurological problems... I don't think so.  He did
  have a little visual tracking problem about a year ago although I'm not
  sure if that isn't the diagnosis of the day.  The Dr. that diagnosed that
  also said he had trouble doing things like lay on back, spread eagle and
  lifting right hand and left foot at the same time and the same on the
  other side.  As I have paid attention more now I notice there are a lot
  of 6 year olds that have trouble with that type of thing.  Have you ever
  tried to teach a 6 year old to do jumping jacks?
  Anyway, he absolutely has a problem "staying on task."  It seems to be
  getting worse but that may be due to the fact that we are expecting more
  of him now as he gets older.  He tested very high on the RAVEN test
  (intelligence supposedly but it seemed to measure spacial aptitude mostly)
  They asked that we put him in GATE which we did and pulled him within a
  week (with the school's agreement) because it was way too fast paced for
  him and he was really feeling inferior.  He is much better at doing
  problems in his head and can express himself verbably very well; however,
  if he has to write anything down or read it is torture.
  The only thing I can think of that is significantly different about him
  from other people I have experienced that may be neurological in nature
  would be the fact that he has never liked soft tickling like you do with
  some kids at bed time on their back or face to calm them.  He almost can't
  stand it.  He prefers you to do harder, faster scratching, like going
  after an itch. ???  He has trouble falling asleep but he is also a very
  deep sleeper and still wets the bed at night about 60% of the time.
  Regarding the EEG?  Are there any dangers doing those?  Was the $1,020
  in line?  Thanks for the tip on UCLA.  We should have known that.
  Regarding your process to diagnose ADD, you mentioned a "Physical Exam."
  Did you mean that litterally?  After going through the process for our
  son as well as for me, I was quite dissapointed at how unscientific and
  subjective it seemed.  Maybe that is just the way it is but I wanted to
  make sure we went through a reliable process.  Is there no physical
  measure (i.e. brain waves either speed or connectedness, chemicals in
  the body, etc.)for ADD?  What do you charge for testing for ADD/ADHD?
  Regarding medication, we would like to use that as a last resort,
  therefore, that is why we are going throuh all of this.
  This is such a great service you offer. However, I feel guilty taking
  so much of your time.  Do you have a way that I could pay for these
  follow-up consults?
  Thanks again!!!  
Dear Carrie James:
This has been a good football season, huh?  About your son.  I just got a report back about one of the children that we follow in our clinic.  He has ADHD (ADD with hyperactivity) who was really a problem in school with behavior problems and bad grades.  We put him on Ritalin and the letter from his teacher today said that he was the intellectual star of her class and a vast behavior change has happened since starting his medication.  Just thought I let you know that medication can and usually does help this disorder.  The medication is safe, non-addicting, and can make a profound difference in learning and school.  The physical exam question was just to make sure that there
wasn't a problem with a neurological condition causes his behavioral problems.  Unfortunately, there isn't a specific test that we can give that will diagnose a child with ADHD.  We take into account the teachers report, parents report, and visual examination of the child while in our office (the least definitive test) to make the diagnosis.  Don't worry about your son doing jumping jacks while on his back.  I bet your pediatric neurologist can't do them either.  I would not do an EEG nor would I pay a thousand dollars to have it read at Harvard.  Some time ago there was a few published reports of children with profound learning disabilities with language loss that some neurologists
found could be helped with steroids.  In their EEG, while asleep they had abnormal activity.  This was a disease named Landau-Kluffner.  Most of the evidence suggests that this disease exists, although rare, but it is not associated with run of the mill ADHD.  So unless you feel like giving Harvard a thousand dollars to read a normal EEG, I would forget about it.  What I could say about the medication would be to ask myself, if this were my child (I have a little boy) with ADHD would I treat him with medication.  It is a tough decision.  I think that in the long run it is a good idea.  It help thems stay on task, concentrate, and in general perform better in school.  There may be some problems with falling asleep or getting up in the morning but that too can be factored into the dosing schedule.  So, the answer to this would be yes, I would treat my son.  The answer to your last question would be to give a donation to your favorite charity or church organization (or synagogue).  Let us know if we can help
with any other information.  Best of luck to your son.  Let's hope we play Ohio State for the national championship in January.
Sincerely,

CCF Neuro:Pediatrics MD, RPS