EEG Readings

[Rickey D.]

I have posted before about the need to keep my 6 yr old daughter on Dilanten after having 1 seizure in mid May. Here are the two EEG interpretations.

5-19-04 (12 hrs post seizure)
1. Focal right temporal slowing mostly in the posterior temporal area at T6 & T4.
2. Presence of 2 electrographic seizures.
3. Presence of spike and slow waves and sharp and slow wave  activity in the rt. temporal and frontal area.

6-15-04
1. Focal slowing in the rt. posterior temporal areas, mostly at T6 & O2.
2. Presence of electrographic seizure with the focus in the posterior temporal area mostly at T6 & O2

She has had no more seizures even though her Dilanten syrum level has been between 4 & 5.1 at 150 mg/day for her 40 lb. body weight. I have resisted recommended increases because she is doing fine at that dose and I worry about side affects plus I am skeptical that she needs any medication at all. By looking at these EEG interpretations one month apart, what is your oppiniion? Do you see any improvement in that time? Do you see a need to raise her Dilanten syrum level to the recommended 10 to 20 even though she has been seizure free since her first episode on May 18?

[nml346]

A related discussion, Seizure activity was started.

[Neonbutterfly]

I would be concerned about stopping meds or going against what your Dr. recommends. My son has seizures but his are not obvious his show up in the form of being spaced out or clumpey he will just stare off to the side sometimes only for a brief time. The seizures also showed up the in form of behavioral issues (due to the area of the brain he has them). Since his were not so obvious to the untrained eye he was not diagnosed for several years after the onset of symptoms. The day he had his EEG he seemed to me to be having a good day I even asked to EEG tech if we should have the EEG when he is doing so well. I was afraid of having an inaccurate test. The results came back with 4 seizures in 40 minutes. I never would have guessed. This is how suttle the symptoms can be.

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

I have not reviewed these EEG's or your daughter's examination and records, and  cannot provide accurate advice over the internet. Both EEG's have demonstrated seizure patterns and abnormal activity in the posterior region in the right side of the brain. There is no difference in the interpretation of these abnormalities between the two studies. You state that your daughter is not having seizures, but I would want to know about subtle seizures such as staring spells or periods of inactivity. Based on these EEG's alone I would recommend treatment for a period of time, or more prolonged EEG monitoring to determine if she is having subtle seizures. If you still are concerned about treatment, perhaps a second opinion with a pediatric epileptologist would be reasonable. If you are in the area we have 4 wonderful pediatric epilepsy doctors. Good luck.