Left mid Temporal theta slowing/EEG results terms clarification

[k2s4ever]

Hi folks:
I am seeing my neurologist next week but just got my hands on the 72 hour ambulatory EEG report and just wanted to do my usual self education ahead of time.
Just looking for some general feedback in terms of what this all means:


- It says there were "23 seizure files and 163 spike detections"

-Overall impression is that the EEG was "abnormal" showing evidence of intermittent left mid temporal theta slowing with infrequent sharp waves.

-The seizure files consisted of movement artifact and vertex sharp waves.

What are "seizure files"?

Thanks, and again-I will be seeing my neurologist for the formal discussion of this, but just want to get a jump on it!

[epileric]

I would have assumed that a seizure file would be a length of EEG with abnormal neural behaviour implying that there was a seizure.

[k2s4ever]

thanks epileric. I also want to note that my informal "Googling" has led me to some articles where, egads, the left temporal theta slowing also has references to Alzheimer's. (lovely, just the sort of thing to see, especially with a family history!!)

[epileric]

Theta is also tied into epilepsy. Check message 15

EEG Neurofeedback

[Nakamova]

Howdy k2s4ever --

The EEG is usually evaluated in tandem with actual clinical evidence -- i.e. whatever seizure activity you've been able to observe on your own. Your neurologist should have all the pieces of the picture, whereas we don't. That said, your EEG report seems pretty straightforward -- spikes and sharp waves are usually indicative of seizure activity, "movement artifact" just means that some small percentage of the data is generated by your movement and isn't relevant to the diagnosis. Theta waves are associated with when the brain is drowsy or falling asleep, which is primetime for seizure activity for most people with epilepsy. (That's the reason EEGs are usually administered with some aspect of sleep deprivation or sedation, so that the patient can be observed while sleepy). So your EEG points to a diagnosis of epilepsy.

[brain]

Not only to add to the post, but also the EEG points
to the location as well; if it stays confined to one
location - you have a very high chances of a betterment
for a future than one who is scatter-brained (like me)
that has seizures coming from all over the place in
the brain. So this is good news if it stays put in one
area.

But in regards to AD, true - there are ties with AD
in association with Theta and Delta waves, but this
isn't the application on your end, even though you
may have a family history of having AD running there,
the chances are very highly likely you will have
follow up EEG's (this is not to annoy the heck out
of you but rather to make an establishment or
history on your case).

It is TRUE, the sooner they catch the seizures
and treat the patient, the better the chances than
those who have been lugging around for a long
time (knowingly or unknowingly).

However on the flip-side of the coin, it may not
even be your "entire life of Epilepsy in your hands".
Why do I say that? You could end up with some
head scans (more extensive scans) and they find
a lesion there that can be removed via surgery;
and lo and behold - no more seizures. Having
stated this: it doesn't give the brain the opportunity
to "learn" to have seizures! That is the importance
of catching it as soon as possible and treating it.

There have been folks out there (including children,
teens, even babies) - whom thought they were going
to be "one of those falling down, frothing at the mouth,
psycho-maniacs" (I am speaking this due to lack of
awareness from the other side of the fence)... only
to find out they had a lesion, was removed, after
so many months of being on anti-epileptic drug or
drugs, the titration was slowly decreased (unless
the situation differs) - and everything was back to
normalcy. However, because they had a taste of
"Epilepsy", many of such individuals become helpful
to those by spreading awareness and/or getting
involved (not all, but some).

I am posting this post from all sides of the fence,
from all different angles, so don't despair - even if
it turns out that you are a person with Epilepsy, it
doesn't mean it's the end of your life; for E doesn't
have to reign in you, you can reign over it!

[k2s4ever]

hey there!
Nakamova: yes, I as much as figured the term artifact meant it was non-contributory really, but stuck in there-meaning it was unrelated to brain activity, the unavoidable capturing of eye movements and skull muscle movements-as you said best, not relevant to the diagnosis.
So it does seem that my EEG is showing that there is seizure activity, or rather confirming it! My symptoms so far have just been a single initial onset of a burning smell which then persists all day. For that the neurologist has suspected probable simple partial seizures. But he indicated it was right temporal lobe related, and this show some left temporal lobe issues. Not surprisingly, the two episodes of the burn smell did not show up at all on the EEG! But I wonder then if I have issues with BOTH temporal lobes. Guess I will be finding out!
I also find it interesting that there were "23" seizure files, and what relevance that is to the fact that the burn smell persists. Again, inquiring minds will be asking the neurologist!! I'm on Keppra for this, 3000 mg/day. I would have to wonder if this is indicative of a med change then!
Epileric: thanks for referencing the comment that the theta slowing also has epilepsy connections too. made me feel better to read that!
Now Brain:
your post was helpful in also talking about AD, and the fact that at least we have an idea of where now the likely seizures are coming from. The burn smell pointed to temporal, and the EEG shows left temporal issues too, though like I said, the instance of the burn smell onset did NOT get detected on the EEG.
I had figured the EEG might still be a stab in the dark knowing that deep mesial issues can be hard to catch, but apparently I have enough readily showing up, so I will see what this all means. Would be nice if I had something they could fix and no meds-no overt lesion was found-have had MRI, MRA and MRV, all showing some anomalies but nothing that screamed out in an alarming manner.

[k2s4ever]

Well, I did see my neurologist, and he's keeping me on the same Keppra dose. The EEG did basically echo what we figured. He did confirm that yes, I do have E, which again, has been the premise from the start. Last month I had a few less of the auras, so he has decided to keep me on same dose and I now don't go back for 3 months, unless something comes up.
I had 13/30 days with the olfactory aura event last month, which is better than the 19 average! I would like to think that maybe the dose (3000 mg daily) is settling in to work, but as we all know, this remains to be seen. If October keeps me at 13 or so, I'll deal with it, but if I get back up to that 19/20 or more range again, I will think about calling. Fingers crossed that it's the upward climb!

[k2s4ever]

I would have edited my last post to add this, but don't seem to have the option to do so. Anyway, I did read a good post on an epilepsy.com forum that describes exactly what I think applies to me with regards to the slowing that was seen in my temporal area:
It was to the effect that this can sometimes occur from seizure activity arising from deeper areas of the brain but by the time it's picked up on EEG, it's just seen as slow waves and not as clear 'epileptiform' or seizure activity.

That's pretty much what my neurologist was getting at.
Also, about Alzheimer's-he told me no, my slowing was not that, it is focal related, so connected to seizure activity.

I just went one straight week plus one day without my aura, but two days ago, this was broken! But no events yesterday at least. But 8 days clear hasn't happened in a LONG time!