72-hour EEG Results - please help me interpret...?

[elizzza811]

...exactly which parts are 'abnormal'? A lot of this may actually be normal. I'll try to summarize the report below, as it is rather lengthy.

Day 1 (first 24 hours):
1142 spikes, 1 spike burst, 19 rhythmic bursts
* Sharp activity multiple times. (No symptoms reported during this activity.)

Day 2 (next 24 hours):
1294 spikes, 0 spike bursts, 46 rhythmic bursts
* Sharp activity multiple times. (No symptoms reported during this activity.)

Day 3 (next 24 hours):
1893 spikes, 1 spike burst, 30 rhythmic bursts
* Evidence of 2 'rhythmic bursts', but unclear if this was seizure activity. (No symptoms reported during this activity.)

During periods of wakefulness:
- 9 to 10 Hz posterior predominant rhythm. It is symmetric.
- Occasional 'central mu rhythm', which is also symmetric.

During periods of drowsiness:
- Loss of background alpha.
- Presence of theta activity.

During sleep:
- Theta activity, sleep spindles, and vertex waves posterior occiptal sharp transients.
- Evidence of independent left and right temporal sharp waves, sometimes occuring independently and sometimes occuring spontaneously. (Do they mean simultaneously?)
- Evidence of generalized spike and wave discharges. Evidence of sharp and slow wave discharges. Both of these occurred more predominantly in the drowsy and asleep states.

Also, apparently none of my events/symptoms (times I pressed the button) seemed to correlate with any of this seizure activity? But then again I had no true 'events' during this 72-hour period (that I was aware of), and apparently most of my seizure activity is occuring when I'm drowsy or asleep anyway? This would explain why my (obvious) 'seizure days' begin with my waking up confused and disoriented, often with severe memory problems (What day is it? What month is it? What am I supposed to be doing today? What can't I remember one thing I did yesterday?), and then later in the day I will get that funny taste in my mouth, feel dizzy, and crash my car or drop the phone mid-conversation 'zoning', for example.

And what is central mu rhythm? From what I've been reading (thus far), it means I have psychiatric problems (which I do...severe OCD).

Any help interpreting this would be greatly appreciated.

[momof3boys]

I wish I knew what all those words meant.... are you scheduled for a follow up visit with your dr soon?

[elizzza811]

Yes, I actually have an appointment on Tuesday. It'll drive me nuts though waiting that long! It must be that central mu rhythm of mine

[momof3boys]

Heck to me thats fast! I had my 4 day video EEG in March, and had to wait til the end of May to get my follow up appointment! And then when I went in, I didnt get to see the dr himself, but got stuck with the PA! I go back at the end of August, and this time I made sure to get the appointment with him!

[elizzza811]

Actually, I had to wait like a month or two to see the neurologist, and then another 2 months for the EEG. The only reason I see her next week is because I scheduled in advance at my last appointment, hoping I'd have the EEG and the results by then.

[Nakamova]

I'd like to help, but your best bet is to ask the neurologist for a detailed interpretation of your EEG. This is because there are so many variables that need to be taken into account with EEGs -- where and when particular waveforms occur, their shape and distribution, their frequencies, the background surrounding them, whether the patient is awake or asleep... And there can be both false positives and false negatives.

Some general info: Theta waves normally are slow waves seen in sleep at any age. In awake adults, these waves can be abnormal if they occur in excess. Spikes can be caused by artifacts in the EEG process. If they occur only on one side of the brain makes them somewhat likely to be abnormal. If there's no "clinical accompaniment" -- i.e. you weren't showing any symptoms at the time, so it's open to interpretation.

Symmetrical sleep spindles are absolutely normal. They show up in many stages of sleep

Sharp waves usually are abnormal, but there are certain settings where they can be normal too. If they are primarily on one side that might suggest that you could be vulnerable to partial seizures.

[elizzza811]

Thanks - they did interpret this EEG as abnormal (sharp waves)...I was just wondering if anything else was abnormal since when I had spike and slow waves on another EEG, they were concerned. I guess I'll wait until Tuesday. I kind of figured the sleep spindles and so forth were normal.

[elizzza811]

I saw the neurologist today, actually the nurse practitioner, which I didn't like at all. She didn't do much as far as answering my questions.

My 'official' diagnosis is 'generalized seizure disorder', not complex partial seizures. She did explain that 'generalized seizure disorder' was a combination of simple and complex partial seizures.

Can anybody give me some of the basics on simple partial seizures? I think I easily recognize when I'm having a complex partial seizure (because I 'zone', lose touch, and can't respond), but how am I supposed to recognize a simple partial? From what I've read, it can be anything from drenching sweats to euphoria to sadness to hearing things to numbness/tingling to burning in the chest?

The NP wants me to call her when I'm up to 100mg of Lamictal to let her know if I'm still having any seizures? And I'd be afraid to say I'm not having 'any' seizures, when I could still be having simples?

And are you allowed to drive if you're only having simple partials???

[epileric]

This link describes the types of seizures pretty well. Also, most places don't differentiate between seizure types. If someone has seizures (of any kind) then they can't drive for X amount of time.

http://www.webmd.com/epilepsy/guide/...their-symptoms

[cmscribbles]

"She did explain that 'generalized seizure disorder' was a combination of simple and complex partial seizures."

Are you sure this is what the NP said to you. Because this is not an accurate statement. Maybe she said you have a mixed seizure disorder? I would seek clarification.

[Nakamova]

Simple and complex partials are NOT considered "generalized seizure disorder." A generalized seizure disorder is one that starts at in one area of the brain and then spreads to the whole brain ("generalizes"). Generalized seizures are divided according to the effect on the body but ALL involve loss of consciousness. These include absence (petit mal), myoclonic, clonic, tonic, tonic-clonic (grand mal), and atonic seizures.

[elizzza811]

Wow...that was what I was thinking, too. But I asked this nurse practitioner if that meant I was having simple partial and complex partial seizures, and she said yes. In fact, I'm OCD enough that I asked her like 3 times, because I thought 'generalized seizure disorder' was different from what she was telling me, too?

Could it mean that my seizures start out as simple partials and 'spread' into complex partials?

[Nakamova]

I think what it means is that the NP got it wrong.

[elizzza811]

I actually did not like this NP at all and made a point of scheduling with the neurologist I so last time for my next appointment. So I will ask her about it in September.

But do you think the NP meant my seizures start out as simples and spread into complex partials? Most of my seizures do start out with a funny taste in my mouth and a dizzy sensation that I am aware of (simples?) and they are quickly followed by a period of 'unawareness' or 'unresponsiveness', lip smacking (compex partials?).

Thoughts? You can have a generalized seizure disorder in which you experience simples and partials, right? I also occasionally (once or twice a year) lose muscle tone briefly in my one leg, too, causing me to fall. Atonics???

[Endless]

Elizza,

Yes, you can have many different kinds of seizures. And you can have a partial (focal) seizure with secondary generalization. That means it starts in one part of the brain as a partial seizure, then spreads to the rest of the brain.

Some people call the simple partials before a tonic clonic (generalized) seizure an "aura." It really is a simple partial that some people get before a more major seizure.

Here's a link to the types of seizures:
http://en.wikipedia.org/wiki/Seizure_types

[elizzza811]

I think that's what she meant...partial seizures with secondary generalization. But when I asked if I was having both simple partials and complex partials, she said yes. So maybe that what she meant. Thanks!