New member intro :o) Hello

[Cubster]

Hello. My name is Colleen and I have four amazing kids. Hannah, 12, Abigail, 9, Gideon 6, and Leah 3.5.

Gideon survived a stroke and has right hemiplegic complex partial because of it. His stroke was in the Middle cerebral artery and damaged much of the frontal and a small amount of the parietal lobe. He's had two recent eeg's done because of episodes of screaming migraines with loss of consciousness and vomiting. He has occasions where he's unresponsive for little snibbits of time and his neurologist says she believes these are focal seizures. I can't seem to get a straight answer from anyone about the significance of the eeg findings though. The report for both eeg's say "No epileptiform discharges are present....focal slowing in the entire left hemisphere during awake and asleep." After the first eeg in he Neurologist said that it was a transcribe error and that the focal slowing is only in the area of damage and this is what you normally see where there is damage...how you tell where the damage is from eeg reading. I asked for a repeat and sure enough, not a transcribe error. She, if this isn't showing the area of damage, what could this mean? We're pushing to have another MRI done and I go back to see his neurologist next week. I was hoping before I do I might get some idea/help as to what I should be asking her. Could the focal slowing be a result of seizure activity that we just aren't getting during the 30 minute eeg?

How's that for my intro post?! :oS

Looking forward to getting to know everyone.

Colleen

[epileric]

It seems a lot of people are wondering about the EEG. Truth is that they might help but not necessarily. I've had EEGS that don't pick up seizures at all. Other times it's only when I"m sleeping & other times only when I"m having a seizure while hooked up. Just because nothing shows up doesn't necessarily mean there are no seizures. The same goes for the MRI. I was 39 before someone finally noticed a little lesion on my MRI but up until then nobody knew what was causing my seizures. The fact remains you kid has seizures so focus on what will lessen them. Finding the cause of the seizures really doesn't make a big difference in how they're treated (unless you choose surgery & I would recommend talking to people who've had it done first)

Meanwhile, make yourself at home, have a complimentary coffee & check out all the nooks & crannies on the site.

[Nakamova]

Hi there Colleen --

There are different EEG readings depending on what's going on in the brain. With some kinds of seizure disorders, the EEG will show wave forms or "spike and dome" readouts that indicate "epileptiform discharges". Your son's EEGs don't show this kind of readout. What they do show -- "Focal slowing in the entire left hemisphere during awake and asleep" -- is consistent with stroke damage, or fluid/bruising in the brain, or with a kind of seizure called a focal seizure. Someone experiencing a focal seizure will appear blank or unresponsive, so that's why your neurologist made that diagnosis. As Epileric says above, an EEG readout or MRI isn't necessarily meaningful, but in your son's case it can make a difference because some medications have a better track record for treating focal seizures. Yup, this stuff is confusing -- definitely ask your neurologist to be as clear as possible, and be persistent in getting her to explain things to your satisfaction.

Best,
Nakamova

[Cubster]

"Focal slowing in the entire left hemisphere during awake and asleep" -- is consistent with stroke damage, or fluid/bruising in the brain

So does that mean even if the entire left hemisphere isn't damages by stroke it would still show slowing in the entire left side? Could it all be damaged yet we just don't see it on MRI? And what do you mean by "fluid/bruising in the brain"?

or with a kind of seizure called a focal seizure.

I have so much to learn...So, would this be something that might happen as a result of a focal seizure in the left hemisphere even if we didn't see seizure activity?

Thank you for walking me through this.

Colleen

[skillefer]

Hi Cubster! Welcome to CWE. Feel free to ask questions, chime in , or just vent in the padded room when needed. Now, as for your question....

Honestly, in over 30 years of seizures, I've only had one abnormal EEG. So don't think that the EEG's are that conclusive. Honestly, the best EEG's are the ones that are done for an extended period of time...

As epileric pointed out, you might not ever be told the definite cause of the seizures. Especially with a history of stroke..they can only really assume. So at this point, don't be upset if they can't give you a definitive answer. Instead, focus on seeing if you can figure out what your child's triggers are, and then, if you can, learning to avoid them. Triggers are foods, activities, sleep patterns, and other things that occur prior to the seizures. If they're avoided, the number of seizures can be reduced...

[Nakamova]

Hi Colleen --

The focal slowing shown on the EEG can mean more than one thing. In general, it usually means that that area of the brain is not as active electrically as it should be. This can be due to a traumatic event (like a head injury causing subdural bruising or fluid), AND/OR that the area is post ictal (seizure occurred and now the brain is less responsive), AND/OR a previous insult such as a stroke, a brain malformation, etc. So while focal slowing doesn't necessarily mean epileptic activity, yes, it CAN be the result of some prior seizure activity. (And as other folks have noted, a seizure disorder doesn't always show up on an EEG. Sometimes it only shows up if the EEG is being done while a person is in the middle of a seizure.)

If this all sounds confusing, that's because it is! A lot of brain disorders overlap in terms of the way they affect the brain, and the way they show up on EEGs and MRIs. So go ahead and ask your neurologist to explain exactly what she thinks of the EEG results and why. Ask her if she thinks there is only one possible answer, or several possible answers. Ask her if she thinks additional testing will be helpful. Ask her if the test results indicate a particular course of treatment/or medication, or if there are more than one treatments to consider.

And ask her to write down her answers, so you can keep a record (especially helpful if you decide you want a second opinion).

Best,
Nakamova

[Cubster]

Thank you for your replies.

We've had an exciting day and Gideon now has a new script for Valproic Acid. This morning we had an episode. Gideon came to my bedroom and told me his head hurt. About 20 minutes later he was SCREAMING, holding his head and refusing to open his eyes. He gets migraines often but they're not like this. I carried him into his room, put him on his bed and started to change him from his PJ's. He continues to scream as though he were being beaten. It was horrible. Suddenly it stopped. He was silent and still, then the froth of mucus came oozing from his mouth. I cleaned his mouth and kept him on his side so he wouldn't choke and waited. He took in a deep breath and coughed a bit and was still and silent and unresponsive. This lasted about 2 minutes and then the screaming started again. He screamed for another 5 minutes then passed out cold. Slightly responsive but as though he was sedated. We took him in to emerg. and they said seizure and sent us home with a script. This is the second time this has happened. The first time was last September and he collapsed twice on that day.

My nerves are shot! :-S

[Dutch mom]

Welcome on CWE Colleen,

Could it all be damaged yet we just don't see it on MRI?

This was the case with our son.
My special needs son has braindamage as a result of non ketonic hypoglycaemia in the first few days after he was born. He was in PICU for 6 weeks where an MRI was done when he was only 4 weeks. The MRI showed no abnormalities by then. How relieved we were... and how wrong...

His development was very slow and at age 2 a new MRI was made; this one clearly showed severe cortical braindamage, diagnosed as typical scarring (two white spaces) as a result of too low blood sugar.
We were told this type of braindamage doesn't show yet on early MRI's, it takes time for the 'scars' to develop. In the affected part of the brain the brain tissue 'dies' slowly or it doesn't develop any further, abnormal or to slow. This makes him microcepahalic (small head, his brain doesn't develop as it should during aging) and he is double handicapped.

When a first MRI doesn't to show abnormalities, a new one later on can, especially with kids who have brains that are still growing and developing.