Video EEGs - any 'extra' electrodes?

[elizzza811]

Apparently there are differences in types of EEGs and in their sensitivity. Specifically, their sensitivity can sometimes depend on where the electrodes are placed...their position.

For example, in the seizure book I'm reading right now, mention is given to several more sensitive 'placements' of electrodes, one of which I believe to be nasopharyngeal??? I can't remember the others right now, but apparently there is some risk involved in placing electrodes in certain areas?

Are any 'extra' electrodes placed inside the nostrils or down the throat during video EEGs by any chance? (Or anywhere else, for that matter?) Electrodes that would not normally be placed during a regular hour-long EEG or during an ambulatory EEG?

I ask because I still have trouble believing that nothing definitive has yet to show up on my EEGs when I'm CONSTANTLY plagued with this relentless jaw-pulling sensation.

 

[momof3boys]

When I had my VEEG done a month ago, they placed all the electrodes on my head, forhead area, and then had moniters hooked up to my chest area to moniter my heart rate. Other than on the head and chest, they didnt have any other electrodes placed anywhere else. I actually have a picture my dad took while I was there! LOL If you want to see it, I will post it for you!

But I will warn you, I look pretty silly! :roflmao:

 

[C0urt]

i have a pic to and I dont mind posting it,
we all look silly dear, it is ok

 

[elizzza811]

Yes, would you please post the pics?

I was truly hoping though that they would attach what my seizure book is calling 'depth' electrodes - electrodes that apparently can present some risk, but that are capable of picking up seizures that traditional EEG electrode placements won't usually pick up? Simple partials are apparently difficult to pick up, according to this book?...which, by the way, is EXCELLENT. If you want a book with a multitude of information and detailed examples on how various seizure disorders can present, and how partial seizure disorders can often overlap psychiatric disorders, this is the book for sure! It gets a little complicates at times, but it is by far the best and most thorough book I've read on partial seizure disorders yet. "Partial Seizure Disorders and Interictal Disorders - The Neuropsychiatric Elements" by David P. Moore.

See, I'm actually beginning to believe that this constant upward-pulling tugging sensation in my lower jaw might be related to simple partials, and originally I thought that complex partials were my only seizure type.

In fact, since this sensation is nearly continuous, I'm even wondering now if I'm in Status Simple Partial Epilepticus, as the constant clenching is completely unwillful, and it feels as if some other being or entity is controlling my jaw muscles and motions day in and day out. And according to my book, simple partials can go status and last for days or even decades! And this is exactly what seems to be occurring with me. The sensation is relentless, and I also seem to have a lot of the symptoms of the personality disorder that can present when a person has been in status too long.

What exactly are simple partials? And does what I describe sound like it could be related to simple partials? Specifically, the jaw tugging sensation is completely unwillful and out of my control, yet I remain fully aware and conscious of it. The book explains simple partials, but I was completely overwhelmed by the revelation last night that this most prominent symptom of mine (jaw clenching) could actually be status seizure activity, so much so that the information didn't absorb properly. I do believe I remember examples of phantom limb sensations or phantom movements of all or part of a limb with complete awareness, yet lack of control...for example, a person with this might be able to sit there and watch their wrists twist themselves into various contortions or their legs jerk rhythmically on their own, unable to willfully stop the motions.

Could my jaw be my 'phantom limb'? And what type of simple partial seizure would this be classified as? I can't exactly watch the jaw motions because it IS my jaw that is involved and it's not within my field of vision usually (unless I'm standing in front of a mirror). But I am both aware, yet out of control?

 

[mel239]

I had electrodes inserted at top of jaw-hurt like hell because I accidentally pulled one out and had to have it reinserted.Will post name if I can recall

 

[C0urt]

was always pretty embarrassing

 

[mel239]

they were called sphenoidal electrodes

 

[momof3boys]

Here is my picture!

This was taken on the day I was admited. I think it was around the time they were giving me my lunch. My dad happened to stop by and see how I was doing at that time.

My pjs turned out to be too big as you can tell in the picture!

 

[elizzza811]

Awww, you both look like...???...little astronauts? little aliens? lol Is it true that a nurse follows you when you have to go to the bathroom?...and does she stand right there?

Those are them!...sphenoidal electrodes were one of the depth electrodes mentioned in my book. Are they glued to your jaw or actually 'inserted'? Those are the ones I'd want. Apparently they can pick up seizure activity that some other electrodes can't.

 

[elizzza811]

Also, what other tests could indicate seizure activity? According to my book, and I admit, I have to read this again, sometimes SPECT and PET scans can shed some light on seizure activity?

Here are my SPECT scan results from September 2006...

Findings: The following perfusion abnormalities are identified:

1) Area of absent perfusion in the posterior aspect of the right parietal lobe.
2) Patchy left anterior and mid parietal areas of absent perfusion.
3) Bilateral perfusion defects in the insular cortex.

Impression: Cerebral abnormalities as discussed above. Although not specific to the diagnosis of neuroborreliosis, this pattern of perfusion abnormality is consistent with this diagnosis.

Could this possibly indicate seizures?

 

[momof3boys]

Awww, you both look like...???...little astronauts? little aliens? lol Is it true that a nurse follows you when you have to go to the bathroom?...and does she stand right there?

Those are them!...sphenoidal electrodes were one of the depth electrodes mentioned in my book. Are they glued to your jaw or actually 'inserted'? Those are the ones I'd want. Apparently they can pick up seizure activity that some other electrodes can't.

Yeap, If you have to get up to use the restroom, you have to push the nurse's button and they have to unhook the monitors and then you can get up and use the restroom. Most of all the nurses I had stood outside the door with the door about 1/4 of the way open. One male nurse said he was not allowed to let me go in alone!? Well at that time I was in the hospital for two days, and they had given me metformin, instead of the brand name, Glucophage XR for my PCOS and I was having terriable side effects. It wasnt til later that evening that I found out from a nurse they were giving me the generic medication, something I tried years ago and had terriable stomach problems with and also "bathroom" problems. So those two first days in the hospital were not good! can you imagine a nurse going into the restroom with you when you are trying to go #2? :roflmao: There was no way in hell I was going to let him in there with me! My mom convinced him to let her go in instead. But yeah, even getting up, the nurses has to be there with you. It sucked!

 

[mel239]

they are inserted deep

 

[Nakamova]

Elizzza --

SPECT scans tend to be used less for diagnosis, more as a secondary presurgical evaluation technique (in other words to help identify candidates for surgery, and confirm areas of the brain where seizures might be originating). EEGs and MRIs are considered primary diagnostic tools. The SPECT scans can be most useful if they are done during or immediately after a seizure (when they will show increased perfusion in the areas of the brain where the seizure manifests), and then also inter-ictally (in between seizures), for comparison. The scans done between seizures can be misleading when taken alone.

 

[elizzza811]

They even have to leave the door 1/4 inch open for partial seizures? They might change their minds if they smell my #2s with all the gastrointestinal issues I experience. Why must they be with me though? It's not like I'm grand-mal-ing.

I also worry about having a video EEG because, as crazy as it sounds, I need to sleep with my head under the covers because the slightest bit of light, even from a street or porch light, can give me insomnia and make it difficult for me to sleep.

Nakamova, I'd like to get another SPECT scan, just to see if it's any worse. But you say there is INCREASED perfusion during a seizure? That might explain why immediately following a seizure my brain feels a sense of relief.

 

[momof3boys]

I have to sleep with it being really dark in the room too. Im a light sleeper.
My first night there, they let me have a "free pass" and not sleep deprive me. I could hardly sleep though. I was taken abruptly off all my medications, and found out by doing that, one side effect is not being able to sleep well. I dont think I got much sleep that first night there. As for light, they leave the bathroom door cracked a tiny bit at night, and sometimes the nurses who come in during the middle of the night to take your vitals, will leave the door half way open so the light from the hallway you will see. But other than that, it wasnt that bad. They had me be sleep deprived the second night I was there. I had to stay up til 3am... now that night I had no problems sleeping! lol

I didnt have a grandmal either while I was there. But how they put it to me, no matter what kind of seizures you have, it was their policy that they have to be with you at all times, if you are out of the bed.

 

[elizzza811]

I guess they're worried that you'll wander out or hurt yourself or something, huh?

I'll have no trouble staying up until 3am though...trouble falling asleep and staying asleep is one of my biggest problems. Ironically, I fall asleep more easily at noon than at midnight.

How long did it take for you to seizure? How many days? And once you had your first seizure, did they allow you to go home? Or did you have to remain there to have a couple more?

This is a pretty good website with information on 'special' EEG electrodes...

http://www.med.nyu.edu/cec/diagnosing/diagnostic/eeg_special_electrodes.html

 

[C0urt]

i just had to use the bathroom with the door open for most of mine.
my last veeg was on a psych ward with no computer or electronics for a week. but i got to listen to the other people, like the people trying to escape and stuff.

 

[momof3boys]

I guess they're worried that you'll wander out or hurt yourself or something, huh?

I'll have no trouble staying up until 3am though...trouble falling asleep and staying asleep is one of my biggest problems. Ironically, I fall asleep more easily at noon than at midnight.

How long did it take for you to seizure? How many days? And once you had your first seizure, did they allow you to go home? Or did you have to remain there to have a couple more?

This is a pretty good website with information on 'special' EEG electrodes...

http://www.med.nyu.edu/cec/diagnosing/diagnostic/eeg_special_electrodes.html

I had my last dose of medications sunday night, then was admited monday morning, I went all day monday with no seizures, and on tuesday at around 2:30pm, I had my first seizure. We calculated I went around 40 hours with no medications and no seizures. They wanted me to have a big grand mal seizure, or at least three "good ones" They can record. I ended up having seizures tuesday into the evening, then they stopped and then started back up wednesday morning and continued into the afternoon and evening. Thursday night I went with mild ones, and had a bigger on early thursday morning. That one they gave me adivan for and then later that day I was put back on the Keppra XR. I was released Friday morning. So after starting the seizures Tuesday, I stayed a few more days and was released.

But after I got home, the next day I had 6 seizures within a half an hour. They were about 5 minutes apart from each other. Thats when my mom had told my dr that years ago I was taken off all my medication and had gone for 10 days with no seizures. On the 11th day I had a ton of seizures, to the point where my primary care dr didnt think he was going to get them to stop. So, after hearing this, my neurologist thinks he should have let me stay longer in the hospital and not put me back on my medication so quickly. He was just hoping that as soon as I had no medications in me, I would quickly have a grand mal seizure. But it didnt turn out that way. I had totally new seizures where I was fully aware of what was going on during them. Something Ive never experienced before.

 

[C0urt]

first time I had one, went a week on no meds, didnt have a seizure, we are in the hallway of the hospital walking past th nurses ward and I have a severe grand mal spend a few days in a coma. they didnt get any info for their time.

 

[elizzza811]

Thanks! But was the relatively short period of time it took you both to seizure in the hospital expected? The gap between my seizures (since I've begun recording them) can run anywhere from 9 days to 37+ days between events. That's a huge reason why I'm resisting the video EEG. I don't want to go into the hospital for 5 days, come out EEG-clean, and then be told I don't have epilepsy - when if I had remained in the hospital another 4 weeks I may have had one.

Also, with regard to the 24-hour ambulatory EEG that I did have done, I noticed that whoever typed it up failed to include my seizure log note that read something like..."None of the events recorded in my seizure log below were anything similar to the events I'm experiencing at home (crashing my car, etc...)." And as a result of excluding this note, they labeled my events 'non-epileptic' in nature.

Should I write a letter and have them correct this? See, I made the mistake of pressing the button every time a sharp pain shot through my temple, or my jaw symptoms increased, etc...just in case these sensations were seizure-related...I wanted to alert them. Had I known that only true seizures would register on EEG, I would have never pressed the button so many times.

And COurt, at least you had entertainment