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Spikes during short EEG but a perfect 3 day EEG??
Thu, 04/25/2019 - 13:09My 7 year old has had stomach pain and vomiting episodes since he was 2-3 years old. We have seen GI, Endocrine, Vestibular Clinic, and Vision...it all led to us being sent to a neurologist in Feb who on a whim said let’s do a 20min EEG since his sister, grandfather, grandmother and great uncle have seizures. Surprisingly to us (because I was for some reason not connecting it to seizures) there were 2 spikes in the Parietal area on his EEG. He never even complained of pain during the EEG but did say his legs felt “sandy” which he often says when he does have diarrhea or stomach pain. So next we were sent to CHOP for 3 nights to have a longer EEG. He of course never felt stomach pain and had no episodes at all! No spikes were on his EEG either. One neurologist said this happens and does not rule out Epilepsy whole the other Neurologist was standing there saying she was sure it was not Epilepsy but Abdominal Migraines. I am relieved that they are obviously not happening every day...but I wanted to know answers too. He gets sent home from school 1-2 days a week for abdominal pain and vomiting, he has trouble with his vision and is tired afterwards his teeth are so damaged because this has gone on for so long, he has a speech problem, visual issues, and is educationally delayed with a high IQ. I had kinda hoped we had finally found out some answers after so many avenues. I realize Abdominal Epilepsy is rare but does anyone have experience and do you have normal EEGs sometimes after a abnormal one?? I’m hoping his neurologist will either do an ambulatory EEG or just treat him for AE to see if it helps. By the way, if it matters, his older sister has focal seizures with SEVERE abdominal spasms but she does not vomit (she does feel like she will loose control of bm) and she has Atonic Seizures. She takes Lamictal and they are almost completely controlled.
Comments
My seizures started in
Submitted by birdman on Thu, 2019-04-25 - 20:05
My seizures started in infancy at 6 months, then I had them with any mild fever. As a young child mom tells me I complained of stomach aches also. Doctors tested for different things. Finally she says I was given Phenobarbital (an anti-seizure medication) and the stomach aches went away. There must have been a relationship with seizures.But Phenobarbital did not cure things. The seizures only got worse as I started to have the complex partials and then the grand mals in my teens. I hope you get some answers.
If his Neurologist bio says
Submitted by Jmaedler on Mon, 2019-04-29 - 22:06
If his Neurologist bio says that she completed her residency training in child neurology and fellowship training in pediatric epilepsy then does this make her a Eliptologist?
Clear EEGs do not rule out
Submitted by Amy Jo on Thu, 2019-04-25 - 17:21
Clear EEGs do not rule out epilepsy (fwiw no test rules OUT epilepsy), particularly focal epilepsy. So the first doctor is correct. The second doctor is wrong about ruling out epilepsy (might just be sloppy terminology use) but could still be right about abdominal migraines. NB there's some thought that epilepsy and migraines are really part of a spectrum. Abdominal migraines usually shift to regular migraines in adulthood. Given all the other issues - really think epilepsy is something to investigate a lot more. Have you consulted an epileptologist - expect the attending neurologists in charge of EMUs are epileptologists but that doesn't mean you were speaking to one. Please follow up with one because they are best in complex diagnosis cases. If they don't make any progress, ask about trialing whatever least problematic medication that might help move the needle on what it is. Your child shouldn't continue to suffer if they can't make progress on a diagnosis and it sounds like significant impact if they don't address this. Either way, consider asking for a sleep deprived EEG a year or so down the road. Epilepsy that's hard to see can change over time (brain changes) so it might help later on (was eye opening for us, saw gobs of seizures years after diagnosis on a stay in the EMU after starting a fast wean).Before my child was diagnosed with epilepsy we explored the possibility of abdominal migraines. My child with epilepsy only had spikes on one early EEG (not the first). The history was classic for focal seizures but most parents wouldn't recognize many expressions of seizures, we didn't know at the time. A good doctor will get an extensive/useful history. I have two other kids who have different kinds of migraines - one is very common symptoms that started in college and the other has visual migraines that are progressing to more common migraines as he approaches adulthood.