Help Me Interpret These EEG Results?

[tom21]

Hello everybody. Ive posted a few times here before, always looking for new answers and insight into an ongoing investigation thats been going on for years. Well just last week I finally got around to actually getting my hands on a 4 year old EEG report that I had actually never seen myself. I always wanted to but never knew I actually had the means of obtaining it for myself (I was 18 when it was done in 2012). Anyways, even though my neurologist thinks nothings wrong with me, I want CWE's take on this. Heres what it says:

This was a sleep deprived EEG tracing using the international standardized system of 10-20 electrode placement.
There is a well developed, posteriorly dominant alpha frequency rhythm seen in a symmetrical fashion. This attenuates appropriately via alerting responses. Low voltage fast activity in the 15-25 Hz range is seen with a frontal predominance.
Note was made of small sharp spike waves in the left anterior temporal region during the midportion of this study.

Conclusion: This was an equivocal sleep deprived EEG tracing. Note was made of small sharp spikes in the left anterior temporal region. These can be associated with cortical irritation/seizure focus, though can also be considered a normal variant as well. Clinical and radiologic correlation is advised.

 

[masterjen]

I think the key word is "equivocal" used in the conclusion part of the report. Your current neurologist feels the EEG results do qualify as a normal variant like the conclusion section mentions as a possibility.
There are two things worth considering:
1. ask for a repeat EEG
2. if the repeat EEG still has an "equivocal" interpretation, consider seeing another neurologist for a second opinion.

 

[tom21]

I think the key word is "equivocal" used in the conclusion part of the report. Your current neurologist feels the EEG results do qualify as a normal variant like the conclusion section mentions as a possibility.
There are two things worth considering:
1. ask for a repeat EEG
2. if the repeat EEG still has an "equivocal" interpretation, consider seeing another neurologist for a second opinion.

ok masterjen, thank you very much. Also, can you tell me what "cortical irritation" means and what might cause it?

 

[masterjen]

I'm not positive what cortical irritation is however I do know that the cerebral cortex is the part of the brain that includes all the lobes of the brain, so you can use that bit of information (I would imagine in your own "google" searches you picked up on this as well). So since the report is saying "small sharp spikes in the left anterior temporal region" this might imply the small spikes are coming from irritation or a possible seizure focus in this area of the cerebral cortex. But as the report indicates the findings are equivocal, meaning that similar findings can be seen in a totally normal EEG. Ask your neurologist at your next appointment and get him/her to explain this further, and ask how it pertains specifically to your case and why he/she interprets this as normal in your case.

 

[Nakamova]

I would also add this:
A positive EEG can help rule in an epilepsy diagnosis, but a negative or equivocal one cannot rule it out. For this reason, neurologists are supposed to use the clinical information (i.e., the actual symptoms you are experiencing) when forming their diagnosis (or diagnoses, if more than diagnosis is possible). The EEG should ideally be used as a supplementary diagnostic tool, not a primary one, especially because some kinds of seizures are too transient or occur too deep in the brain to be recorded.

Cortical irritation basically means an irritation to any of the brain's cortices (such as the visual cortex or cerebral cortex). The irritation can take the form of lesions or swelling or brain trauma. It can be related to or result from seizures, but it sounds as if the EEG result was not striking enough to point to a particular cause. A single EEG will not always produce clear results, and often, additional EEGs (preferably sleep-deprived) are required to provide clarification.

As Masterjen notes, this suggests that a repeat EEG would be helpful.

 

[tom21]

Thanks everyone