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Dr. Abhijeet---Please Help with EEG

If anyone cares to take a stab at this, I'd appreciate it.....I had 2 EEG's and this is the impression on both results.

Abnormal recording with excessive left temporal theta activity.

Anyone?  Does this mean I'm crazy?  LOL (kidding)
I am an MS "limbo-er" and was just wondering if this was related in any way to that or something else....I also have CENTRAL sleep apnea which disrupts my sleep in a MAJOR way....(Why is this type of sleep apnea so unknown?)
Thanks for any input...
19 Responses
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Avatar universal
bumping up....thanks
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.
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Bumping Again....sorry for the impatience....
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368886 tn?1466235284
MEDICAL PROFESSIONAL
Hello.

Theta waves originate in the Hippocampus, an important structure in the deep parts of the temporal lobes. Theta waves on EEG are normal if taken in sleep. And they are normal in children even in wakeful state. But in adults, theta waves in alert state are abnormal. They suggest a dysfunctional temporal lobe.

Do you have symptoms suggesting temporal lobe dysfunction?

Central sleep apnea is less known as it is less common. Obstructive sleep apnea is more common.

Regards
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Avatar universal
Thanks so much for your response.....

I am not sure what temporal lobe dysfunction is, but I will copy and paste a previous post with my symptoms, etc.....This is one that you have already answered....

I am a 39 year old female that has had the following symptoms over the past 10 months: (Sudden onset)
CENTRAL sleep apnea episodes--was diagnosed at Sleep Clinic
Memory loss, trouble 'finding' proper words, electrical sensations in arms and legs, "lightning" in right eye, clumsiness, dropping things, bump into things, muscle weakess in arms and legs, some hallucinations (but I know immediately they're not real), retrieving wrong word when speaking, etc...I know there are other things, but cannot remember.
I have had an MRI with the following findings:
**Multiple small foci of increased T2 signal noted predominantly in the subcortical frontal white matter bilaterally and to a lesser extent in the deep parietal white matter. There are definitely greater than ten T2 signal abnormalities noted in the white matter. Perhaps one questionable peri-ventricular focus of increased T2 signal adjacent to the right frontal horn. Questionable tiny focus of increased T2 signal in the anterior pons eccentric to the left.  Questionable tiny focus of increased T2 signal in the anterior medulla as well.  No other findings noted intracranially.  
IMPRESSION--Multiple white matter signal abnormalities as described above.  The are most likely on the basis of demyelination and the appearance would be concordant with a clinical diagnosis of multiple sclerosis  MR follow up to document dissemenation and time may be performed, if clinical symptoms persist. ****
Thanks
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Avatar universal
Bumping.
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Bump.....
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Please see above
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Avatar universal
Have you been diagnosed with MS?  
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368886 tn?1466235284
MEDICAL PROFESSIONAL
Hello.

I have read the earlier conversation on the MRI. And I was in favor of MS and starting medication.

Have there been any communications with your neurologist over the last couple of weeks? I guess you perhaps need to do the CSF tests, too, if not done already.

The MRI does not show any temporal lobe problem. But since the EEG shows abnormal waves, it is significant.

Regards
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Avatar universal
Thanks so much again, for your response.....You are appreciate more than you will ever know!
I have seen my Neuro and he is now sending me to an MS Specialist soon.....(?)
I had an LP, but found out he didn't even test the spinal fluid for MS...He explained that he had limited spinal fluid and was very concerned in ruling out more dangerous, very fatal things. ie: Cancer, Prion Diseases, TB, Meningitis, etc....
He also told me that those O bands are also seen positive in people with strokes and many bacterial infections....He felt it necessary to use the limited spinal fluid to test for the other stuff......Needless to say, I was still confused.....
It seems, for some unknown reason, he still doesn't feel comfortable with an MS diagnosis....So why send me to an MS CLINIC?
Thanks, again doctor....
Still Confused,
Tammy
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PS---Both the Neurologist and the GP say that the EEG results mean "nothing"????????????????????
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Somebody please slap me.....
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335728 tn?1331414412
SLAP!!!

I say RUN don't walk from your "neurologist" as soon as he makes an appointment for you with an MS Specialist!

I can't believe he did an LP and didn't even check for Oligloconal Bands...call his office on Monday morning ok and see if they have found an MS Specialist for you and if they haven't, call your family doctor and let them know you need an MS Specialist right away!

Enough time has been wasted with this useless Neurologist that does an MRI looking for MS that "Multiple white matter signal abnormalities as described above.  They are most likely on the basis of demyelination and the appearance would be concordant with a clinical diagnosis of multiple sclerosis" but then does an LP afterwards and doesn't even look for MS!!!

Oh Honey...get away from this guy please!

I am SO GLAD that you are in the MS Forum now and please stay over there ok?  We will guide you as to what to do and we welcome you with open arms!

Lots of Hugs,

Rena705
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Avatar universal
Thanks Rena.....I sent you an email  :)

I would love to hear what Dr. Abhijeet thinks as well..


Tammy
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368886 tn?1466235284
MEDICAL PROFESSIONAL
Hello.

The O bands, IgG Index would have helped the MRI diagnosis. And the other conditions mentioned here do not come into picture. You would have been hospitalized in intensive care if you had TB meningitis and Prion disease. Cancer is a distant entity. Prion disease, especially, is a rapidly progressive dementia with myoclonus, and often leads to death within 6 months!!

I guess you will benefit from the MS clinic.

As far as the EEG is concerned, if your EEG recording was in a waking state, it shows temporal slowing. It has to be correlated clinically.

Regards
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Avatar universal
Thanks so much again for your time and opinions....I can't thank you enough!

I will just wait to see when my app't with the MS clinic is, and hopefully won't go insane in the mean time....  :)

PS---I was definitely awake during both EEG's and they both showed left temporal abnormalities.....My Neurologist said that it "doesn't mean much".....Is there ANY truth to that, or is he just waiting to see what happens, (as usual)
Thanks again!
Tammy
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368886 tn?1466235284
MEDICAL PROFESSIONAL
Hi.

There are some reports of studies done on adults to see the normal EEG patterns. One of the studies show that theta wave pattern in the anterior temporal region may be seen in normal awake adults, but that could have been during states of drowsiness. This may suggest that theta in adults is normal. It is not. Only a certain number of people may have the theta waves in awake EEGs, but we don't know if they were fully alert.

The whole point here is that it is better to err on the positive side. It will be a pleasant surprise to find out that the suspected EEG abnormality was not significant. But it won't be a nice thing to know the initially deemed normal and ignored EEG changes turned out to be significant.

In multiple sclerosis, there is a correlation between slow waves and demyelination. Wave patterns from 6 - 10 Hz (theta to alpha) have been noted in MS.

Here's a line from a study done by Leocani et al, in 2000, titled "Electroencephalographic coherence analysis in multiple sclerosis: correlation with clinical, neuropsychological, and MRI findings." And the line goes as ".....Compared with controls, patients with multiple sclerosis showed increased theta power in the frontotemporal-central regions..."

Regards
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Avatar universal
Now that I replied to the wrong post the first time, I'll try again!

DR. ABHIJEET:
Thank you for your reply.  I do appreciate all you do for people on here that are confused, angry, scared and curious.  There are not many doctors out here that would take the time as you do.

I will keep you informed as to the STERN talk I will be having with my Neuro....
Thanks!
Tammy
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