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abnormal 1 hour EEG but normal 6 hour EEG

Mon, 09/18/2017 - 13:37
My 6 y/o was referred for an EEG because of staring spells from her teacher. Her 1 hour EEG was abnormal with TIRDA and spikes and waves. MRI was normal and a follow up 6 hour EEG was normal. She did not sleep during the 6 hour test and he was not sleep deprived like her 1st EEG. Her neurologist said that the likelihood that this is epilepsy is dramatically reduced and that it "just happens sometimes" that EEGs are abnormal. We are questioning if we should get a second opinion to be sure that there is nothing to worry about or just wait and see how it plays out with the staring into space/potential attention issue. Really happy at the thought of nothing wrong but confused at the same time.

Comments

Yeah, get a second opinion!

Submitted by Amy Jo on Mon, 2017-09-18 - 17:10
Yeah, get a second opinion! MRIs are often normal for epilepsy patients but does help in some cases. EEGs can be normal and one can still have epilepsy. Sleep and sleep deprivation increase the chances of finding something on EEG but that's what they do to help uncover what is there. EEGs with epilepsy related activity occur in a small percentage of cases, usually it is epilepsy but if there is another neurological condition, abnormal epilepsy related activity without epilepsy has a higher chance of occurring (still a small chance overall tho' and note epilepsy is often a more common comorbidity with other neuro issues).Of course for my child I want her to sleep well because it used to be that not sleeping well was a guarantee of a seizure. But getting the proper diagnosis is different from reducing triggers to avoid seizures.My other reason for a second opinion ... does your gut think that everything is FINE? If not, get a second opinion. The drift of your post sounds like you might think something is off. Generally with epilepsy parents are in denial/shock or very relieved to find out what is wrong.

Yeah, get a second opinion!

Submitted by Amy Jo on Mon, 2017-09-18 - 17:24
Yeah, get a second opinion! MRIs are often normal for epilepsy patients but does help in some cases. EEGs can be normal and one can still have epilepsy. Sleep and sleep deprivation increase the chances of finding something on EEG but that's what they do to help uncover what is there. EEGs with epilepsy related activity occur in a small percentage of cases, usually it is epilepsy but if there is another neurological condition, abnormal epilepsy related activity without epilepsy has a higher chance of occurring (still a small chance overall tho' and note epilepsy is often a more common comorbidity with other neuro issues).Of course for my child I want her to sleep well because it used to be that not sleeping well was a guarantee of a seizure. But getting the proper diagnosis is different from reducing triggers to avoid seizures.My other reason for a second opinion ... does your gut think that everything is FINE? If not, get a second opinion. The drift of your post sounds like you might think something is off. Generally with epilepsy parents are in denial/shock or very relieved to find out what is wrong.

Our backstory might be like

Submitted by Amy Jo on Mon, 2017-09-18 - 17:24
Our backstory might be like yours - our child's kindergarten teacher was the first to report repeated staring. A LOT of people (including doctors and even a neurology NP) thought it was absence and nothing on EEG pretty much clears out the chance of absence. Our child's neurosurgeon told me one can't jump to assuming that (he specializes in epilepsy). Turns out it wasn't absence, she was having complex partials (shows up like staring sometimes).  After the staring was noted, a lot of family mentioned it had happened around them too in the prior year. It just became notably worse because we never got a seizure at that time on EEG. We did get spikes with a sleep deprived EEG. Our child also complained of classic and not classic common partials - abdominal pain, bad smells, bad tastes were the more common types. The neck pain she complained about a lot was not but decreased every time we increased a medication that only treated partial seizures.So I don't know what kind of doc you are dealing with but you need a pediatric neurologist or epileptologist. Not a pediatrician, prefer a neurologist who really is on top of things as lots of people assume staring means absence.Later on we saw atypical absence, which isn't just staring and wasn't anything like the complex partials which did a whammy on our child's memory.

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