Hydrocephalus

My one year old girl is Hydrocephalus and she was shunted when she was 12 weeks old. She had EEG at that time and it showed some minor abnormal activities on her brain even though she has never shown any sign of seizure. She has been on phenobarbital for about 7 months but she has not have any seizure. Her neurologist says she has to be on phenobarbital for 2 years. My questions are 1)if the EEG shows some abnormal activitries, does it nessecerly mean it is seizure? and 2)if there is no sign of seizure, shoud we still give phenobarbital?

[JainMD]

Hi,
I feel sorry that you and your family, specially the little one has to go through all this. Well regarding EEG, Electroencephalography is a noninvasive technique in which the electrical activity of the brain is recorded from the scalp to evaluate the function of the brain. It is important to distinguish between cerebral activity and artifactual discharges of biological or non-biological origin.
Bioelectric artifacts include ocular, cardiac, respiratory, movement, muscle, and sweat artifacts. These various artifacts have characteristic appearances that facilitate their recognition. Artifacts may also arise from the equipment or electrodes and especially from variation in electrode impedance.
Other artifacts may arise from the environment in which the recording is made, such as from other electrical equipment, intravenous infusion lines, and static electricity generated by nylon clothing.
The EEG is important in the evaluation of patients with known or suspected epilepsy. The inter-ictal occurrence of epileptiform activity in a patient with an episodic behavioral disorder that may represent seizure activity increases markedly the probability of epilepsy.
I think the clinical co-relation is more important.
If there are any known electrical disturbances in EEG pattern without any artifacts, then I think he has to be on phenobarbitone for long term till his EEG is normal.
Keep me informed if you have any queries.
Bye.