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Old 12-27-2010, 11:06 AM
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Invasive EEG


I suppose this isn't a new topic, but I am wondering what an "invasive EEG" is. I just (well, at the beginning of the month) spent a week in the hospital connected to a "mobile EEG". I had all the normal stuff connected, but had like a 100ft cord, and was free to roam about in quite a large space. They took away all my meds pretty quickly, and I was on constant visual recorded monitoring as well. Actually I don't really remember much of the week. I went into the hosp. (Abbott, down in Minneaplois) went in on Tues. morn, and I remember some of that day, but don't have any recall of anything else until sometime Sat. and even that is pretty fuzzy. Actually the first day I really remember is Mon. of the following week. Weird, and very scarey. Friends and family said I either called them or they called me, and we talked, and I seemed to be ok to them, but I have absolutely no recall of any of that. Never had that happen before. I had 7 seizures in that time, 1 tonic clonic, and the rest were complex partial. Is this normal? And, is this what you mean by "invasive" or is that something else? I am looking into a lobectomy, but haven't as yet heard anything from them.
Thank you anyone for some input.

CJ
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Old 12-27-2010, 11:15 AM
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Q: Did your doctor suggest the invasive EEG to you?

An invasive EEG is when they go inside the skull and put the electrodes on the surface of the brain or inside the brain. This is usually only done as a pre-surgical evaluation to pinpoint where the seizures are coming from, so they know where to operate. You would need to be considering a lobectomy very seriously for them to do this procedure. It is usually only done pre-surgery.

Here's a good string on another site:

Quote :
Though it is a little bit technical, here is an excellent document that
describe how it "actually" works.
http://www-vf.bio.uu.nl/lab/NE/scrip..._Interface.pdf

In more human language, it comes down to the following.

The invasive or the depth EEG test requires implanting electrodes
temporarily into the brain. Obviously, the head must be absolutely still
during this procedure. Your head will be placed in a frame that is pinned to
your skull. CT or MRI scanning will then help the doctor decide where the
electrodes should be placed. With great care and precision, the neurosurgeon
drills through the skull, so this will cause you no pain, but some people
experience discomfort despite the use of local anesthesia. After the
operation, you'll probably have a nasty headache. Your head will be wrapped
in a bandage, and your scalp will be sore. It will take about a month to
heal after the procedure is done. Depth electrodes, also called subdural
electrodes, are generally not used in those areas of the brain that affect
speech or movement, to avoid causing damage. Once the depth electrodes are
in place, EEG information is collected directly, a process called
electrocorticrography. If a single focus is found, the next step may be
surgery to remove it. Otherwise only the electrodes themselves are removed.
http://www.medkb.com/Uwe/Forum.aspx/...6/Invasive-EEG
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Old 12-27-2010, 11:36 AM
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AAHH SOO! I didn't think that was what I had done because in my opinion, it wasn't very "invasive". Just had to ask. No, they haven't suggested that, and by the sounds of it, I don't think it would be very fun. I have did have a WADA test done, about 2 weeks ago. That was very interesting. Man the things they can do. It's crazy!

Thank you, again for the info!

CJ
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Old 12-28-2010, 12:01 PM
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cjole,

Endless is correct about the "invasive EEG". I had a Left Temporal Lobectomy done years ago. Prior to the lobectomy, I had to have had the WADA test and the invasive EEG done, also. I was in the hospital with the electrodes inside my skull for 7 days so they could better monitor where my seizures were originating from. Wasn't as painful for me as the actual lobectomy.

Make sure you ask your dr. plenty of questions before he/she operates. Are you sure you want the procedure done?
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Old 12-29-2010, 01:22 AM
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Hello cjole.
It sounds like you had a video-monitored eeg. I had one in April, and it was no fun at all. 14 seizures in 3 days, and I have limited memory of the whole event, other than nurses asking me where I was, and some projectile vomiting.

However, the testing was helpful, and I had a left temporal lobe resection in June. The recovery has been very slow, and I still tire easily, but I haven't had any seizures since. The surgery was definitely worth it, although I was very frightened before I did it. But seizures are frightening too, and maybe I won't have any more. They say it will be two years before they will feel confident that my seizure-free state will continue.

I wish you the best going forward, and if they choose to do surgery, I hope things work out as well for you as they have for me.
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Old 12-29-2010, 09:21 AM
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Originally Posted by dbrownpilot View Post:

However, the testing was helpful, and I had a left temporal lobe resection in June. The surgery was definitely worth it, although I was very frightened before I did it. But seizures are frightening too, and maybe I won't have any more. They say it will be two years before they will feel confident that my seizure-free state will continue.
Since you had a left temporal lobe resection, have you yet suffered the depression that seems to accommodate the surgery as well as memory loss?

Since it's only been 6 months since you had the surgery, it is a bit too soon to tell what the outcome will be. Hopefully, in your case, you will remain seizure free. I had the surgery on the left side and was seizure free for only 14 months, the seizures came back worse after surgery than before, so that is why I said in my previous post to cjole to check out all options before undergoing brain surgery.
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Old 12-29-2010, 10:44 AM
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I haven't had any depression yet, I hope that doesn't happen either.

I've heard about a lot of people who start having seizures again. I'm hopeful that won't happen me. Since the seizures were clearly being started in the vascular malformation, (as indicated on the video eeg) and they were able to remove it and the surrounding tissue, they said my chances were good.

I'm sorry to hear about your situation. I'm sure that it is terribly discouraging. I hope they can develop some meds which can help.
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Old 12-30-2010, 07:17 AM
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Thank you, everyone, for your replies.

Cint you said you had your surgery years ago. How many years has it been? Do you think maybe they have "refined" the surgery some in that time so that maybe the outcome is not so bleak? Sorry to hear the outcome was so bad for you.

No, I am not SURE I want the procedure done, or if I even qualify yet. With my situation, I am HOPING this may be an option. I have a pretty high tech job, with alot of responsibility, and it's beginning to even affect my ability to perform. It's starting to scare me. Peoples lives could be in my hands. It hasn't been a problem until about the last 6 months, when my seizures began to increase, and become more variable in the types.

Haven't heard any thing from them yet. I expected a response by now, but maybe I am a little impatient. I don't know how long it all takes. I was mistaken also about the time line. I had the monitored EEG in the first part of November, and then the WADA in the first part of December. My memory is so fried lately. My closest friend thinks I've gone loopy. Seems like I can't remember ANYTHING, and what I do remember is much different from what she says actually is the truth. Personally, I think she's nuts! LOL

Pilot, I hope things continue to go well for you. Please keep me posted. It may help me in my final decision.
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Old 12-30-2010, 09:03 AM
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Originally Posted by cjole View Post:
Cint you said you had your surgery years ago. How many years has it been? Do you think maybe they have "refined" the surgery some in that time so that maybe the outcome is not so bleak? Sorry to hear the outcome was so bad for you.
I had a LTL done back in 1990 and, yes, the surgery has been refined some since then. The neurosurgeon was going to do another brain surgery, but after more testing, discovered the damaged area was too deep in my hippocampus and if they were to go in and remove it, I could end up like an end stage Alzheimer patient. My memory is bad enough since surgery, so no thanks.
I've tried numerous drugs and have the VNS now. Mine was on the left side and the prognosis for Left Temporal Lobectomies aren't as good as for the right-sided ones. Here is another website discussing surgery types:
http://www.epilepsy.com/EPILEPSY/types_surgery

Another interesting article:
It's About Time: Long-term Memory Outcome Following Temporal Lobectomy
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867081/
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Old 03-11-2011, 01:36 PM
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Cjoel,
I had an invasive EEG done about five weeks ago at the Mayo Clinic in Rochester, MN. There are a couple kinds of invasive EEGs, generally it's depth electrodes, which are inserted into the brain through a burr hole in the skull, or grid electrodes, which require a craniotomy. I had the grid electrodes, since my MRIs were all clear and the surgeons weren't able to pinpoint exactly enough where my seizures (simple-partial) originated. This proceedure is not something you do unless you are SURE that you want surgery. I had a grid of about a hundred electrodes put onto the surface of my brain. They closed me up (minus the bone flap, which they froze) and took me off my meds for four days while measuring my seizures. After they had enough data, I went back into surgery and they took off the grid and performed a resection of the tissue from which my seizures were originating. It's been five weeks and so far I'm seizure free! (I used to have seizures almost every day).

Invasive EEGs are only done for difficult cases, so be sure to ask your doctors about exactly what the possible side effects are/why your case is so difficult before you go ahead and have the surgery. If you've exhausted other options, like I had, surgery might be worth it. My seizures were right between my motor and sensory strips but all I lost was a little functionality in my right hand, which I've now gained back.

Good luck!!

Erica Egge
I'm chronicalling my preparation, surgery and now recovery, is livinginabrainstorm.blogspot

Last edited by epileric; 03-11-2011 at 02:27 PM. Reason: inserted link
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Old 03-11-2011, 08:12 PM
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Congrats on your surgery, hope all goes well with you. I finally got the results of my EEG and WADA at the end of last month. I had 7 seizures back to back after 4 days of being w/o meds. They finally had to stop them. I actually got to see the videos of it, and it was IMO very informative. My memory of that week is VERY fuzzy. I remember going in on Tuesday, next thing I know, it's Friday, and even that is very "fuzzy". That part really freaks me out. Guess I was calling people and having "normal" conversations, don't remember at all. One of my friends, however, told me I said something about a body I had buried somewhere??? I dunno, maybe I have a dark side that I'm not aware of??

Anyway, they have isolated them to all on one spot on my left temporal lobe. It's near my speech center, so IF I were to elect to do surgery, we would have to do that grid test to further isolate it, and to ensure that they can get to things w/o adversly affecting my speech. I have talked it over with the doctor, and she is suggesting at this time that we hold off, as my seizures have been pretty well controlled lately, and MAYBE we have come to a point where I can control things without the invasive stuff. (fingers crossed)
However, I still have concerns about my job, and how things are going here. I guess I have resigned myself to the fact that my life will never again be "normal". I don't like that, but guess we all have things we have to deal with in that respect.

I do have concerns that I don't know how or what to do. All of the seizures that I had in the hosp. were in the early am. I am single, live (and sleep) alone. How would I know if I am having seizure while I'm sleeping? For all I know it could be going on all the time. I wake up some mornings with a sore tongue, and that makes me suspicious. But I have no concrete proof other than that. My dogs don't talk.

Anyway, enough babble, gotta get back to the hockey tournament! State highschool. Big stuff here in Minnesota!
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Old 03-14-2011, 10:16 AM
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I'm glad they were able to isolate your seizures but sorry about where they are. I don't have an MD or anything close, but don't give up on surgery. Once they finish the invasive EEG, they won't do a resection unless they think it's safe.

As far as your living situation, I live alone, too. Did any of the seizures you had in the hospital happen while you were asleep? Mine did, but they all woke me up, which was comforting. However, if you're nervous, you could set up a camera by your bed to record you and see if you have any seizures in your sleep. I've never done that, but it's an option you could try.

I'm a Minnesotan, so I understand the hockey - I hope you won!
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Old 03-15-2011, 10:27 AM
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Originally Posted by cjole View Post:

Anyway, they have isolated them to all on one spot on my left temporal lobe. It's near my speech center, so IF I were to elect to do surgery, we would have to do that grid test to further isolate it, and to ensure that they can get to things w/o adversly affecting my speech. I have talked it over with the doctor, and she is suggesting at this time that we hold off, as my seizures have been pretty well controlled lately, and MAYBE we have come to a point where I can control things without the invasive stuff. (fingers crossed)
However, I still have concerns about my job, and how things are going here. I guess I have resigned myself to the fact that my life will never again be "normal". I don't like that, but guess we all have things we have to deal with in that respect.
Yes, we do all have things we have to deal with. I will never be "normal" either, whatever "normal" may mean.

I originally had to have the grid testing done to precisely pinpoint where the seizures were originating from. Then they went ahead and did the lobectomy and, as I said before, I was seizure free for 14 months. Then they suggested another brain surgery, but since the testing showed that the seizures were coming from my left temporal lobe, near the speech and memory center, the neurosurgeon refused to go there, saying I could end up literally speechless.

So in your case, "if it ain't broke, don't fix it." If your seizures are under control with the meds, then I see no need for surgery. The only reason I went for surgery is because I was having 4-5 complex partial seizures a day even while taking meds.
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Old 03-15-2011, 01:22 PM
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when I went for a video EEG 2 wires were placed at top of hinge of my jaw.I was so out of it that I dont remember it happening,but when I pulled one out a couple days later,it was awful pain when they put it back in.Is this something different than the invasive where they put your head in a vise?
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Old 03-17-2011, 06:22 AM
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A term flashed in my head it was sphenoidal-those were the wires that hurt
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Old 09-04-2011, 01:45 PM
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I am a 52 year old female who has never been seizure free..... every few years I decide that I am fed up and need some answers. Yes, the technology is better but I know that I am a poor surgical candidate and on 3 drugs I still have seizures, without any auras so basically I am on high alert at all times. Not a good state for a busy brain. I have taken a course on meditation, MBSR and I believe it is helpful, as is Yoga. I am now seeing dr's who are telling me that I have NON epileptic seizures as well as simple partial and complex partial seizures with a tendency to spread under stress, sleep deprivation and hormonal influences. There are days when I am afraid to leave home although home can be a pretty dangerous place to be. I just tried to reduce Dilantin, introduce Lamictal while maintaining Frisium and Keppra. I had a few grand mal seizures as a result of Dilantin withdrawal and then I got the infamous Lamictal Rash.
Is anyone else allergic to Sulfa drugs? Apparently sulfa allergy is a sure sign that Lamictal will likely be problematic. I am off to NYC this week for a 72 hour ambulatory eeg. Apparently the technician doesnt work on Mondays and I will have to remove the electrodes myself, drop them off at the hospital and go directly to the airport. I need to know the best way to get all the glue out of my hair so I am presentable enough to get on the plane! I need to be inflammable as well.......
Any hints would be greatly appreciated.
Thank you in advance,
Dd
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Old 09-04-2011, 03:51 PM
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I don't know about the medication allergies, besides the fact that prolonged Dilantin use can really decrease your bone density, among other adverse effects, so if there's any chance you can get on something else, I definitely recommend trying. I do, however have glue advice. As far as going somewhere straight from your appt, all you can do is put your hair up or wear a hat. Once you get a shower/bath tho, I've found copious amounts of Suave and a comb to work best. Takes forever, but it works.
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