Help with EEg Report

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krice2004

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Hello, I am new to this as of today. My 12 month old has just had her eeg last week and I have the report. We are scheduled this Friday with a peds specialist but am worried sick of the wording in this report. Any insight or advice, opinions welcome.
HX- At 4 months had a febrile seizure with fever spike above 104. Recently in the past month she had an "episode" of passing out, which we were later told by her pediatrician it was a type of seizure. Leaving the doctors literally after 10 minutes she had another one in the car this time with the head extension, and shaking. Turned around and took her to er. Her bloodwork showed slight dehydration due to being recently sick, her CT was normal and urinalysis was normal also. Before and after these happen she is right back to her normal happy self. There was no fever present at the time with the 2nd seizures. Er dr said she may have symptoms of early epilepsy. Here is the full report from the EEg. Any insight in to any wording in any of this would be greatly appreciated. Thanks in advance!

Eeg diagnosis: Dysrhythmia grade 2, of the left temporal, parietal, occipital.

Findings: 3 - 4 cycle per second activity was noted during light stages of sleep to 70 - 80 uv in amplitude. Then the pt went into deep sleep. There were several runs of one half cycle per second slow delta activity in the left posterior temporal, parietal, occipital region sometimes occuring in runs. This activity was 350 uv in amplitude and clearly was asymetrical compared to the opposite hemisphere. This was noted several times throughout sleep. This persisted throughout sleep.

Clinical impression: there is asymmetry in sleep rhythms with very slow monorhythmic delta activity recurring in runs in the left posterior temporal, parietal, occipital region. Imaging in this child might be indicated because of the asymmetry in sleep patterns.
 
There are only three grades of dysrhythmia, so grade 2 is right in the middle. Any of the "grades" can be indicative of a seizure disorder, including grade 1. However, dysrhythmias can be caused not only by epilepsy, but also by things like anxiety and other psychological states.

Assymetry and slowing can sometimes suggest a structural issue like a lesion. So when it says "imaging might be indicated", that means that an MRI might be useful to rule something like that in or out.

There's no mention of spikes or sharp waves (which are often associated with epilepsy).

I think the wording of this report is very general -- there are no red flags that jump out -- but the pediatric neurologist should be able to give you a more complete interpretation based on all the available info.
 
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