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Abnormal EEG-

Thu, 10/26/2017 - 14:25
A few months ago, my daughter (8) had a sleep study to test for possible sleep apnea. As a result of that test, we were told she had several spikes in her brain while she was sleeping and we were ordered a sleep deprived EEG to follow up. The result of that test showed more spikes. I was told she doesn't necessarily have epilepsy but that she's possibly as risk for it and we were referred back to the neurologist. Because she's considered a new patient, all new patients appointments are scheduling way out right now. The nurse said she was going to talk to the dr (who is on vacation this week) because my daughter needs to be seen right away and they'll have to fit her in as soon as possible. We have never noticed any type of seizure behavior from her. I've conferred with her teachers and they've not noticed anything either. No muscle spasm, no staring off, no tics, nothing. I did do some reading on this site and saw people posting about dizzy/fuzzy spells, so I'm going to gently ask her if that's ever happened to her. I guess my questions are: 1. Is this unusual to have the spikes but no seizure activity? 2. Are there other symptoms that I don't know about that she could have had that I missed? 3. Should I be concerned that they want her in ASAP or is that standard? 4. Most importantly: What questions do I need to make sure I ask at the appointment? I want to make sure I get all the info that I need and usually take pen and paper to appointments. I'm definitely worried but not panicking. Just trying to wrap my head around this and get all the info I can so I don't walk into that appointment unarmed. Thank you!

Comments

Answers:Spikes are also

Submitted by just_joe on Thu, 2017-10-26 - 18:14
Answers:Spikes are also called epileptiform as are waves and all are also seizure activity if they are on the EEG that is looked at by a neurologist and they are looking for epilepsy. Understand that there are other things that stem from the brain and they may look for spikes in them also. Ailments like Parkinson's, ADHD or even PTSD.Research the learn section. If you have ever seen her day dreaming then she could have been in an absence or even a focal seizure.The sooner they see her the faster they can start treatment. and possibly the cause.Questions to ask.... The different types of epilepsy she has. The different types of seizures she can have. How she should take her meds. Make sure if they say 2 times a day when those times need to be. Mine told me 2 times a day. I have them verify that by how far apart should those times be. As close to 12 hours as possible.You might want to look at the EF My Epilepsy Diary which can be looked at by clicking on any of the pages including near the bottom of this page or right to the left upper side of this page.If you like the neurologist and have a good relationship with them by all means ask questions whenever you have a visit. She still has a few seizures what do ne need to do to control them better?  Is she doing better now that she is on the medications even though she is taking her meds? For every question my neurologists asked me I had at least one for them. They helped me get control of my seizures and not only reduced the number to a seizure every 8-14 days. They also reduced the time in them to a few seconds. You wouldn't know I had a seizure even if you were watching me when I had one.

What caused you to do the

Submitted by Amy Jo on Fri, 2017-10-27 - 03:36
What caused you to do the sleep study? Excessive snoring, tiredness or some other issue?1. While it’s possible to have epilepsy related discharges without epilepsy, it’s unusual. 2. It’s really easy to miss seizures, there are so many ways they can be felt/experienced (depends on location affected in the brain) that your list doesn’t touch on. Plus seizures for some people might only be during sleep or soon after waking. For kids a feeling that they now consider normal is their only symptom that a seizure occurred (for them), so they may consider the situation normal.  Our child’s seizures are mostly feelings. Some partials she recalls such as pain or a strange feeling in her abdominal area, pain in her neck, bad smells, bad tastes or hearing that someone is whispering far away (only on her left side, her spiking was on her right side so it makes sense). Complex partials she can’t recall and mess her memory up for hours after, those are staring (no movements) for an extended period of time that we can sometimes catch. And then there were some generalized atypical absence and myoclonics I never could catch during an EEG a few years after the initial diagnosis but are completely controlled by meds.3. It isn’t clear why there’s a reason to rush over other new epilepsy cases. Maybe their office has some poor scheduling but otherwise there’s a general lack of neurologists so it’s common to book out months.4. I’d ask: what was seen on the EEG to warrant a rush on the first appt? what kinds of seizures are a possibility? if meds are suggested, ask how meds are chosen, how the doc’s office  works/communicates with families to adjust dosages, what the common and dangerous side effects are for the top two med choices a doc has, what the doc thinks the first med should be, and how to contact the office during off hours if bad seizures or side effects occur. Would the doc recommend emergency medications, what constitutes a seizure emergency (most seizures are not emergencies but a small percentage of seizures can cause immediate damage and can be deadly but not everyone get those).  I would also ask if a neuropsych eval is appropriate now. And then what kind of school accommodations might be needed, that’s it’s own topic really.

ps - You could probably call

Submitted by Amy Jo on Fri, 2017-10-27 - 17:11
ps - You could probably call the neurologist's office and ask if they might want to arrange for an MRI before you can get in. If the discharges indicate a possible focal issue, then an appropriate MRI might explain why the discharges are there. It may not be something serious, just something that explains the abnormality.  Odds are any MRI is unremarkable, may see something that you find scary but people's brains can differ without there being a problem.  If the concern over apnea was borne out and it is possibly central apnea, you'd want to see that the follow up includes imaging that includes imaging of the base of the brain. Our child's first neurologist wasn't really good at explaining about an odd pattern seen on the initial EEG, didn't seem like something they were familiar with - well, it's completely normal for someone who has had a burr hole drilled in their skull and my child has that so it would be odd to not see that pattern. So sometimes there's something unusual in a report (EEG, MRI, whatever) that sounds scary in medical speak but really isn't a problem. Neurologists seem to think they really know something about imaging but I must say that they get all worked up about stuff that the neurosurgery office shrugs off and the neurosurgery office has no problem pointing out something is odd (when they know you don't freak out, otherwise they might word it more carefully) and is completely upfront with an explanation that your child's brain imaging is different and they don't know why (maybe we just know those people better but we can exchange 'wtf' looks over this stuff and laugh). Still, if there isn't a clear problem, they don't freak out vs the neurologist's office has refused to call me back if something is weird. So ask for or get a copy of the report so you have something to refer to later (EEG, MRI, whatever).

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