A related discussion,
Abnormal EEG was started.
your welcome.
CCF Neuro MD
Dear Mary and Randy:
I do not get the same feeling about the intrepretation of the EEG as what was written. One can see spike and wave formations upon going into and out of sleep in a youngster. It is also normal in some people to see burst of polyspikes with hyperventilation in a young child or even an adult. I would get a second opinion from a pediatric epileptologist before I would conclude that the EEG is abnormal. That is my opinion.
CCF Neuro MD
I finally received a copy of the second EEG and was wondering if you could respond to it since you were very helpful of the first. It was done approximately six weeks after the first one. It states:
The background rhythm during awake is 6-7 Hz, moderately well organized and develped, bilaterally synchronous and symmetrical. Photic stimulation produced no change. Hyperventilation was associated with brief bursts of generalized, polyspike and wave without symptoms. Occasional generalized bursts of spikes were noted, and spike and wave and polyspike and wave were seen with drowsiness and sleep. None of these were clinically asymptomatic. During sleep, several muscle and jerks and twitches were noted without any EEG abnormalities to accompany.
CLINICAL INTERPRETATION: This EEG is abnormal due to the presence of interictal activity consistent with seizure disorder on treatment.
How does this compare to the first in terms of does it still show the same type of Epilespy or seizures? Also what is the difference between "spike and wave" vs "polyspike and wave" and what does interictal mean?
Thanks,
Mary & Randy
your welcome
CCF Neuro MD
Thank you for your responses. We will wait and watch now. We will try to discuss some of these things with our son's neuro. She does not seem too interested in finding any causes, however. She seems to just want to medicate, which is why we have turned to the internet to look for causes. We may try to get a referral to a new neuro depending on how the next few visits go. We do not want to wait until our son goes drastically down hill. Again thank you. Your responses have been much appreciated.
Mary & Randy
Dear Mary and Randy:
The difficulty with trying to correlate a disease with symptoms over the internet is not being able to see the child and the work up. The slow anterior waves are worrisome, and likely are not a post-ictal response. That is why I mentioned the diseases associated with progressive myoclonus seizures. The workup and time will tell. Just a note: mitochondrial diseases are associated with myoclonic seizures, constipation, kidney abnormalities (RTA), eye problems (retinal and eye muscles), hypotonia, muscle weakness (usually episodic), cardic problems and autonomic dysfunction. Some or all of these symtpoms may be present.
CCF Neuro MD
Sorry, I just looked up some of the conditions you mentioned and realized that some of them are metabolic disorders. However, after reading about some of them I wonder if he would show signs of some sort of deterioration or other symptoms besided the fevers and seizures(He also has a slight heart murmur(detected recently) and some constipation at times which I forgot to mention, but an EKG was done and they don't feel that is anything to worry about. The constipation has been mentioned to the doctors, but they don't seem too concerned about that and it is not something that is constant and is taken care of by natural methods(eating more fruits, karo syrup, etc)).
Mary & Randy
Thank you for your quick response. Yes, you were right to assume that he is developing normally(physically & mentally). He has been a very healthy boy up until this last year and in a way still is except for the fevers and seizures. What do you mean that the "The slow 2.5 hertz frontal or anterior waves are also very worrisome." and what does it indicate? I also forgot to ask if any type of deficiency could be the cause of all of this or if a metabolic disorder could cause this. Thanks again.
Mary & Randy
Dear Mary:
Sorry to hear about your son. I will assume that your son is a completely normal boy and developing normally, with the exception of the fevers.
The EEG is worrisome, even if it was performed post ictal. The slow background might be the result of the ictal event, but the spike wave formations are indicative of epilepsy. The slow 2.5 hertz frontal or anterior waves are also very worrisome. Now, I need to tell you that reading the EEG is somewhat subjective and without reading it myself I can only speculate if I was reading what you are telling me.
The abnormalities of the first EEG are likely present on the second EEG or the neurologist would have told you (?). The symptoms of short myoclonic like movements is also not a good indicator. Valproate is a good medication for these type of seizures.
Allergies would not have anything to do with his seizure events. The many seizure events, myoclonic, occurring is troubling. Myoclonic epilepsy in a 4 year old may signal a progressive epilepsy. There are several conditions that might give rise to a progressive condition, Unverricht-Lundborg disease, sialidosisl, Gaucher's disease, mitochondrial disease (this would also induce high fevers of unknown etiology), Lafora's disease, and neuronal ceroid lipofuscinosis. I think I would ask to rule out these diseases.
Sincerely,
CCF Neuro MD