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Please help me with my EEG report

Sat, 02/21/2009 - 01:22

Hello everyone....I'm new here and I was wondering if anyone could help me understand my EEG results. I have an appointment next week with a neuro but I'm really wanting to know what it means now. I have had two grand mal sz since last Nov.  This is what it says on my report....

Hyperventilation was performed without abnormality.

Photic stimulation was performed without abnormality.

Throughout the recording there was a rare T3 sharp wave noted.

This is an abnormal EEG due to the presence of potential epileptiform activity from the left temporal lobe at T3. Clinical correlation is recommended.  

Can anyone put this into plane English for me?

Thanks

Brook 

Comments

Re: Please help me with my EEG report

Submitted by juperee on Sat, 2009-02-21 - 13:40

Hi, there, Brooke!

Basically, they're saying they saw "epileptiform" (epileptiform: shapes that tend to show up on EEGs of people with epilepsy) spikes or waves mixed in with your normal resting brainwaves. Normal alpha brain waves hum along more or less sinusoidally at about 8-12 Hz, but a person with a tendency towards seizures occassionally shows a narrower but higher voltage spike mixed in here and there, even when not having a seizure or feeling anything unusual at the time. 

Your occasional spike was the "sharp wave" they referred to, and it came from near the T3 electrode on your temporal lobe.

The hyperventilation and photic tests were done to see if those two things are "triggers" for increased epileptiform spike activity. In your case, they were not. (The photo-sensitivity test, where they flashed the lights in your eyes, only is a trigger in about 5% of people.) They check for these triggers to see if they're situations you need to avoid. Other potential triggers are sleep deprivation (big one for me), hormonal fluctuations (in about 1/3 of women with temporal lobe epilepsy), alcohol overuse, etc., and of course, the ever-popular "random and inexplicable" variety.

Then when the EEG report says "Clinical correlation is advised", that means the doc should ask if you experience actual symptoms that are consistent with temporal lobe epilepsy, such as frequent deja vu or other "simple partial seizures".  The thing that's interesting about temporal lobe epilepsy (simply means that the source of the voltage spikes is in your temporal lobe as opposed to somewhere else) is that 90% of folks with abnormal EEG results in the temporal lobe do experience seizures, but the reverse is not true. Some people have clinical symptoms of TLE but never manage to catch anything on the EEG, which leads to some frustration diagnostically. At any rate, that 90% level with EEGs in TLE is way tighter correlation than what is seen with a seizure focus in a different part of the brain.

Some folks with epilepsy have a seizure "focus" where the spikes start in one specific are of the brain, usually leading to a focal seizure that only affects that area, but a focal seizure can spread over the whole brain and lead to a grand mal like you experienced. Other folks have "generalized" epilepsy, where with no warning the whole brain gets involved and leads to a grand mal (generalized tonic-clonic is the preferred term, but everybody says grand mal anyway).

It's cool that your clinic gave you a copy of the interpretation of your EEG. Some don't. I pasted mine at the end of this comment for you to compare. Pretty similar to yours.

So, don't panic; the neurologist will evaluate everything and, with your input, figure out a course of action. 

I too was diagnosed with left temporal lobe epilepsy after a grand mal seizure, and I assure you, life goes on.  Take care, and come on back here anytime for info, support, and a few laughs.

--jules

PS: recommended links:

http://my.epilepsy.com/epilepsy/epilepsy_temporallobe

http://my.epilepsy.com/epilepsy/seizure_simplepartial


 

Hi, there, Brooke!

Basically, they're saying they saw "epileptiform" (epileptiform: shapes that tend to show up on EEGs of people with epilepsy) spikes or waves mixed in with your normal resting brainwaves. Normal alpha brain waves hum along more or less sinusoidally at about 8-12 Hz, but a person with a tendency towards seizures occassionally shows a narrower but higher voltage spike mixed in here and there, even when not having a seizure or feeling anything unusual at the time. 

Your occasional spike was the "sharp wave" they referred to, and it came from near the T3 electrode on your temporal lobe.

The hyperventilation and photic tests were done to see if those two things are "triggers" for increased epileptiform spike activity. In your case, they were not. (The photo-sensitivity test, where they flashed the lights in your eyes, only is a trigger in about 5% of people.) They check for these triggers to see if they're situations you need to avoid. Other potential triggers are sleep deprivation (big one for me), hormonal fluctuations (in about 1/3 of women with temporal lobe epilepsy), alcohol overuse, etc., and of course, the ever-popular "random and inexplicable" variety.

Then when the EEG report says "Clinical correlation is advised", that means the doc should ask if you experience actual symptoms that are consistent with temporal lobe epilepsy, such as frequent deja vu or other "simple partial seizures".  The thing that's interesting about temporal lobe epilepsy (simply means that the source of the voltage spikes is in your temporal lobe as opposed to somewhere else) is that 90% of folks with abnormal EEG results in the temporal lobe do experience seizures, but the reverse is not true. Some people have clinical symptoms of TLE but never manage to catch anything on the EEG, which leads to some frustration diagnostically. At any rate, that 90% level with EEGs in TLE is way tighter correlation than what is seen with a seizure focus in a different part of the brain.

Some folks with epilepsy have a seizure "focus" where the spikes start in one specific are of the brain, usually leading to a focal seizure that only affects that area, but a focal seizure can spread over the whole brain and lead to a grand mal like you experienced. Other folks have "generalized" epilepsy, where with no warning the whole brain gets involved and leads to a grand mal (generalized tonic-clonic is the preferred term, but everybody says grand mal anyway).

It's cool that your clinic gave you a copy of the interpretation of your EEG. Some don't. I pasted mine at the end of this comment for you to compare. Pretty similar to yours.

So, don't panic; the neurologist will evaluate everything and, with your input, figure out a course of action. 

I too was diagnosed with left temporal lobe epilepsy after a grand mal seizure, and I assure you, life goes on.  Take care, and come on back here anytime for info, support, and a few laughs.

--jules

PS: recommended links:

http://my.epilepsy.com/epilepsy/epilepsy_temporallobe

http://my.epilepsy.com/epilepsy/seizure_simplepartial


 

My EEG report for comparison

Submitted by juperee on Sat, 2009-02-21 - 13:40

******************
Date: 03-29-06

CLINICAL INTERPRETATION: There is a single left temporal sharp wave present. This is suggestive of a tendency to have seizures arising from that head region. There is also increased amplitude of activity and focal slowing over the left temporal head region, suggestive of a focal disturbance of cerebral function. Clinical correlation is advised.

EEG CLASSIFICATION: Asymmetry gr. 1 increased left temporal; Dysrhythmia gr. 3 single left temporal sharp wave (wake) ; Sleep--no activation ; EKG monitor.

REPORT: The EEG background during wakefulness consists of 9 Hz alpha activity in the posterior head regions. There is a single left temporal sharp wave present at rest. There is no additional activation during photic stimulation and with hyperventilation. There is increased amplitude of activity and mild focal slowing in the left temporal head region. During the recording, the patient fell asleep spontaneously. There was no epileptiform activation during the sleep.

The EKG monitor was unremarkable.

*******************

******************
Date: 03-29-06

CLINICAL INTERPRETATION: There is a single left temporal sharp wave present. This is suggestive of a tendency to have seizures arising from that head region. There is also increased amplitude of activity and focal slowing over the left temporal head region, suggestive of a focal disturbance of cerebral function. Clinical correlation is advised.

EEG CLASSIFICATION: Asymmetry gr. 1 increased left temporal; Dysrhythmia gr. 3 single left temporal sharp wave (wake) ; Sleep--no activation ; EKG monitor.

REPORT: The EEG background during wakefulness consists of 9 Hz alpha activity in the posterior head regions. There is a single left temporal sharp wave present at rest. There is no additional activation during photic stimulation and with hyperventilation. There is increased amplitude of activity and mild focal slowing in the left temporal head region. During the recording, the patient fell asleep spontaneously. There was no epileptiform activation during the sleep.

The EKG monitor was unremarkable.

*******************

Re: My EEG report for comparison

Submitted by juperee on Sat, 2009-02-21 - 13:50

And, just for grins, how 'bout the one from July 2008. It's more specific about the region of origin:

 

  • CLINICAL INTERPRETATION: There are potentially
    epileptogenic abnormalities in the left anterior temporal region, consistent
    with a partial seizure disorder. There is also focal slowing of brain activity
    in the left anterior temporal region.
  • EEG CLASSIFICATION: Dysrhythmia grade 3 left
    anterior temporal lobe spikes (wake and sleep).
  • REPORT: The duration of the recording was 51
    minutes. During wakefullness there is a 10Hz alpha activity in the posterior
    head regions. There is intermittent theta and delta slowing in the left temporal
    region. There are left anterior temporal spike wave discharges present at rest.
    There is no additional activation during photic stimulation and with
    hyperventilation. During the recording, the patient fell asleep spontaneously.
    There was continued activation of the left anterior temporal spike wave
    discharges during sleep.

 

And, just for grins, how 'bout the one from July 2008. It's more specific about the region of origin:

 

  • CLINICAL INTERPRETATION: There are potentially
    epileptogenic abnormalities in the left anterior temporal region, consistent
    with a partial seizure disorder. There is also focal slowing of brain activity
    in the left anterior temporal region.
  • EEG CLASSIFICATION: Dysrhythmia grade 3 left
    anterior temporal lobe spikes (wake and sleep).
  • REPORT: The duration of the recording was 51
    minutes. During wakefullness there is a 10Hz alpha activity in the posterior
    head regions. There is intermittent theta and delta slowing in the left temporal
    region. There are left anterior temporal spike wave discharges present at rest.
    There is no additional activation during photic stimulation and with
    hyperventilation. During the recording, the patient fell asleep spontaneously.
    There was continued activation of the left anterior temporal spike wave
    discharges during sleep.

 

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