Can an EEG be wrong or change over time?

[ilovetorun]

My son has every single classic symptom of benign rolandic epilepsy. Our ped thought that was what it was for sure, but when the EEG came back, the spike pattern was unilateral, and he said that they are usually bilateral. He said that it still could be BRE since our son is showing absolutely no problems other than two 30 second episodes in the last 6 weeks. Neruologically and cognitively, he's fine. He's coordinated and gettng straight A's with no change in functioning. My Dr has ordered an MRI due to the atypical spike pattern.

My quesiton is this. Could an EEG done today produce a different result than one done a few days ago? Also, would the results be skewed since he never actually fell asleep. He was too worked up to actually sleep. I'm still hoping for BRE and our Dr said that it very well could be, but I'm still nervous as heck that it's something worse. Our MRI is tomorrow. Thanks for any help.

 

[Nakamova]

Yes, EEGs can vary, and the interpretations can vary as well. And despite what the pediatrician said, BRE spikes are not usually bilateral:

With BRE, the spikes can be confined to one hemisphere or occur bilaterally. In fact, the spike focus is unilateral in about 60% of BRE patients. In 40% there are bilateral spike foci on either an initial EEG or later ones. With BRE, unilateral spikes do not have a predominance in either the right or left hemisphere. When the spikes are bilateral, they can be synchronous or asynchronous, symmetric or asymmetric.

So your son's EEG doesn't rule out BRE at all. And if his actual symptoms are a close match for a BRE diagnosis, that's another reason to make that call.

 

[ilovetorun]

He has every classical symptom. He's 8. He would feel a tingling in his tongue and a twitching of his cheek. Remained conscious and had a memory of it all. Actually alerted us to it both times it's happened while he's been awake. Said that his tongue tingled once and woke him up. Duration was 30 seconds max. EVERYTHING points to that.....even out ped said that he thought it was that because it was a classic case, until he saw the EEG. Thanks for the input. That helps me so much. Guess he's just ordering the MRI to be extra cautious.

 

[Nakamova]

Yes, I agree that the MRI is just to be extra-sure. I think it's pretty standard these days to order up an MRI whenever anything neurological is going on.

 

[ilovetorun]

I know logically that the likely outcome is that the MRI will find nothing. But dang, the stress is about to give ME neurologial symptoms! Unless there is some sort of brain tumor that causes no other neurological symptoms except a twitching cheek and tingling tongue, as well as an inability to speak and some drooling. Which I doubt!! He did give us 50/50 odds that it was still BRE instead of another sort of focal epilepsy, depsite the EEG.

 

[Nakamova]

And remember, the EEG doesn't rule out BRE at all since unilateral spikes are actually common with BRE.

 

[Maemae]

My 11 year old daughter was recently diagnosed with benign rolandic epilepsy. She had had 2 seizures 4 months apart. Her EEG pattern was not typical of BRE though (he said it originated in a different area). He still believes this is what she has...anyone else have this experience?

 

[Belinda5000]

an EEG can change overtime were your sz's are coming from different places.
My last EEG I had spikes and it was so deep they didn't know where it was.