EEG questions

[greenguy]

Hi. I'm not currently epileptic. However, my case has been intensely focused on this issue and more ...

I'm a 32-year-old male ... had subdural hematoma with burr hole evacuation 4.5 years ago, accompanied by epidural hematoma in lower spine which resolved on its own. Other than some headaches and occasional tingling sensations, I have been free of seizures or other neurological issues ...

A recent EEG report included the phrase "could correlate with intermittent cerebral dysfunction." I have not had any seizures, and am not aware of anything with my neurological condition, but ...

My neurologist has not shown much motivation to help or illuminate the subject (when I asked about environmental factors affecting the EEG, he said no, that's "just the way your brain is"), I'm very concerned that my work may be in jeopardy.

I'm wondering if anyone has input or opinions regarding the following report ... and what are the chances that abnormalities could be related to fatigue, stress, and construction noise next door at the time of EEG???

I have to get an MRI and neurological assessment. Should I get another EEG?

I have a small sub arachnoid cyst that was noted at the time of my subdural hematoma. Noone has been concerned about it during or since that time, but my review has currently mentioned that as a potential issue. Is this a concern?

I'm not looking for medical opinions directly - anecdotal thoughts, experiences, and observations are great. Thanks!

(I can accept my condition if it's accurately observed, however I don't want to have my life even more disrupted due to transitory, incomplete, or inaccurate observations.)

*** EEG report ***

Background activity is dominated by intermittently seen 9-10 Hz rhythm seem posteriorly bilaterally and symmetrically. Intermittently, trains of theta and sharp theta are seen disrupting the background especially during somewhat sleepy intervals, but without clear-cut epileptiform features.

Drowsiness is seen throughout much of the recording, probably explaining some of the intermittent theta activity.

During more of the alert portions of the record, the background becomes more regular with alpha activity dominating, and without the intermittent interruptions by theta and sharp theta.

Hyperventilation produced a modest increase in intermixed theta rhythms. Post hyperventilation, a single sharp waves [sic] localized to the left posterior temporal region is noted on several occasions.

Intermittent photic stimulation produced some modest posterior driving.

CLINICAL SUMMARY: Patient with posttraumatic encephalopathy, rule out epileptiform activity.

EEG INTERPRETATION: Mildly abnormal EEG. The intermittent theta activity and sharp theta is nonspecific but could correlate with intermittent cerebral dysfunction. Diagnostic epileptiform activity as such is not noted.

[RobinN]

I want to Welcome you Greenguy to CWE. Great bunch here with a variety of knowledge and stories. Over the next few days I am sure you will hear from others.

My daughters story revolves around 3 EEGs. The first one after her first two seizures at the age of 14 was abnormal. I was able to see the paper document as the neurologist thumbed through it, and stopped on pages of interest. She was place on Tegretol
Her second EEG was following incidents of vision loss, which later was connected to the medication, but was frightening to say the least. At that time the EEG appeared to be normal.
The third EEG was done at a different office. There was no activity noticed at this time. Then a fourth EEG was done with video. Not quite 24 hrs, but that was what it was classified. She did not have a seizure so there was no activity shown on the tape.
I am told that you must be having a seizure to have an abnormal EEG. There is even a link that Bernard found that stated that if the seizure was in the front lobe that many times the EEG was normal.

So for my daughters situation, the EEG was not something we could rely upon to tell us the story. I most definitely believe the test is not a GOLDEN ticket. In fact in our case, one doctor didn't even request a previous test to compare the results. So how important are they?
For us it is the MRI and the MRA that was more important. Of course they are only as good as the person that is reading them. We had two neurologists telling us that the heterotopia was important and a focus of the seizures, and yet another neurologist saying it wasn't of any importance. I think each test would just help support another.

Rereading your post, I see you have not had any seizures. Are you having any other type of episodes? I think some times the tests can be more frightening then day to day life. We place so much emphasis on them, and yet they certainly are not 100% infallible.

I hope others will give you their take on the more scientific nature of your questions.
Hope you find some answers with the other testing and that you have confidence in your doctor.

[Birdbomb]

Welcome greenguy

An EEG is not necessarily a definative answer. Many people with epilepsy can have "normal" EEG's. There can even be epileptic seizures that don't show up on an EEG. It's all in the interpretation in conjunction with symptoms, medical history, and test results.

Got to love the ambiguity of modern medicine!

My nephew had had subdural hematoma with burr hole evacuation after a fall off a skateboard several years ago. He was very lucky not permanent damage was done ( but if you ask me, ALL skateboraders are brain damaged!)

[Bernard]

Hi Greenguy, welcome to the forum.

Sounds like the EEG report showed abnormal theta activity, but it wasn't strong enough (or frequent enough) to classify as epileptiform according to whatever standard threshold they use.

I'd highly recommend you look into EEG Neurofeedback. It can help normalize the theta activity and hopefully prevent any kindling of the abnormal activity.

We have one member here who is facing the prospect of surgery to correct an epidermoid cyst that is putting pressure on the brain, however, it appears that this may not be an option for sub arachnoid cysts.

[brain]

ALL skateboraders are brain damaged!)

Excuse me for one moment

::: slaps Birdy:::

I am a skateboarder and I am not
dain bramaged!



-----------------------------------


GreenGuy

Love your ID!

EEG's aren't always inconclusive
nor are they always conclusive,
but they can give you a generalized
idea of what's going on in your head
sometimes - but not all of the time.

If I were in your shoes, I would press
on to have a routine EEG for monitoring
and to follow along for progress and to
have an established history. So don't
be surprised if it goes up and down from
all kinds of readings throughout the time
span and period.

But if at any case you are not happy with
your current Doctor, then you can always
ask for a 2nd opinion or see another Doctor.

[greenguy]

Thank you all for the replies so far!

Sounds like the EEG report showed abnormal theta activity, but it wasn't strong enough (or frequent enough) to classify as epileptiform according to whatever standard threshold they use.

That's the impression I have. I'm just trying to figure out how subjective this stuff is. I think I've seen that being sleepy, emotional, or meditating can make theta increase. While I have not experienced seizures and I haven't seen the EEG output, I'm trying to get a feel for what it means ...

I'd highly recommend you look into EEG Neurofeedback. It can help normalize the theta activity and hopefully prevent any kindling of the abnormal activity.

Thank you for the link. I'm reading ... if anyone has more info or experience please let me know!

[Birdbomb]

Excuse me for one moment

::: slaps Birdy:::

I am a skateboarder and I am not
dain bramaged!



[/size]

I stand uncorrected....


*****WARNING****** Graphic injurys
Here are skatboarders doing what they do best...crashing. There are TONS of videos like these. Do you see an epidemic of brain injuries in the future? I do.

[Bernard]

[brain]

Hey How come I wasn't in any of those
videos??

I did some pretty good tricks in my heydays!
Half Pipes, Full Pipes, 360* air, but of course
today they have names for them just like
they changed names Tonic Clonic for Grand
Mal; but of course we didn't have helmets
back then but I wore elbow pads and knee
pads and my skateboard wheels were first
metal and then became polyurethane's which
ate up nearly 2 months' worth of my entire
allowance!



I was even on Skateboarder Magazine in
1975 and again in 1978; one for speed and
one for high scoring tricks. I hit my head more
on the freaking HIGH DIVING BOARD than I did
from the skateboard parks!

<--- strong supporter of Westside

::::: sulks :::::

[RobinN]

WoW Sharon I am impressed. Quite the risk taker.
Did you know a pro, named Ty ? around the same time?