Child's abnormal EEG results

[Lollsb]

Thanks for answering the questions of the confused.  I am one of the confused. It’s regarding my 7 YO daughter’s sleep deprived EEG report, which is from MGH in Boston.  It was ordered to rule out absence seizures (she’s a big daydreamer but her teacher was concerned some of her daydreaming episodes were "unresponsive.")  No electrographic seizure activity was reported but they found intermittent asymmetry, with slower frequencies over the right posterior quadrant during both drowsiness and hyperventilation.  Photic stimulation had no significant response.  Awake state showed a symmetric, reactive 8.5-9.5 Hz, 35-75uV background over both hemispheres.  She had a MRI last week and the results were normal, which her doctor felt conflicted with the EEG results.  No plans at the moment to redo the EEG or do an ambulatory EEG as there has not been more "episodes" since early March. What can this mean?  I feel like I am back at square one with no answers.  Why would this focal slowing occur in just drowsiness and hyperventilated states? Are there are symptoms or behaviours that might manifest from slowing in this particular part of the brain?

She does not have migraines but is susceptible as both my husband and I get them. There’s no family history of epilepsy except 2 great great uncles. No prior brain injuries. She has some attentional/focusing issues, is high energy, and emotionally intense but doesn’t seem to completely fit the picture of ADHD (we've had neuropsych. done). She was also identified as creatively gifted this year.  Could it all be related?

[CCF-Neuro-M.D.-PW]

First of all, if the doctor who ordered the test cannot interpret the results, then perhaps he should refer you to someone who can (and there are plenty at MGH or in Boston). I cannot give you any kind of formal interpretwtionof the results, particularly without seeing the tests.

A certain amount of asymmetry in the EEG can be normal. However a persistent degree of asyymetry adn slowing, can represent a structural lesion, but an MRI would show this up. Posterior slowingin the EEG can occurin migraine, usually during an attack. Posterior slowing can also occur in absence epilepsy usually on both sides. Hence it could mean a few things depending on the actual appearance of the EEG

A normal EEG does not exclude epilepsy, so perhaps a second more prolonged EEG (2-3 hours) can increase the yeild of the EEG to pck up anything abnormal if present

Good luck

[jan]

I have had slowing during drowsiness and hyperventilation on a few or more EEG's, also.  I was told it was a structural lesion, it doesn't show up on my MRI's, although other lesions do.  I am still being monitored due to a suspicion of epilepsy.

[Lollsb]

If you don't mind me asking, what symptoms prompted your initial EEG?  Did you have an ambulatory EEG as well?

[jan]

The initial symptoms years ago were spells of extreme tiredness, but the eeg was normal and left at that.  Then about 2 years later, in '01, I started having different kind of spells and the one that started all the investigation and diag of E went like this: I heard a buzzing noise like a bee, then hallucinated a bee, then went into a dreamy state, then felt like something was overcoming me and I couldn't do anything about it.  The next thing I knew my friend was looking at me really weird and asking me what I was doing.  She said I was staring straight ahead and waving my arms over my head (automatisms).  I was diag with complex partial seizures.  

I had maybe one abnormal eeg after that with just the slowing then.  Next I had a 48 hr VEEG (video eeg done in hospital) and had slowing,sharps,and spikes (minimal) and was given the diagnosis.

I was on meds 3 yrs. and have had only one abnormal and the rest normal EEG's since, even a 5 day VEEG.  I was taken off meds and am now being followed.  I was real hopeful of getting dischg'd, but at the last appt. the epi said he is suspicious of me having seizures deeper in my brain than the eeg can pick up.

I have had other "spells" too,hardly any now.  Some with just buzzing, some I get dizzy then things go black and I start to fall.  Partial seizures can cause all different type of symptoms!


Let me give you a link to a great forum for E.  Everybody is very kind and helpful there.  You can ask any questions you have.

http://brain.hastypastry.net/forums/forumdisplay.php?f=133