Need help with understanding EEG results

Bookie123

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Hello. My daughter has been having regular seizures since Nov/2014 and I just received the report from her EEG and I do not have a clue what it means and I am hoping someone can help me so I do not lose my mind waiting to see her newly appointed Neurologist at a seizure clinic.

EEG report
Classification: Dysrhythmia grade IV right occipital posterior temporal spikes. Delta Grade II Bioccipital

Report: Alpha - none
Delta - 1.5 - 3 hertz, high voltage, arrhythmic, bioccipital, persistent; small amount, generalized
Theta - 4 - 6 hertz, medium-high voltage, semi-rhythmic to rhythmic, generalized, moderate amount
Spikes - Frequent, medium voltage at O2 spreading at times to T6
Sleep - symmetrical V-waves and spindles with no additional activation
EKG - sinus rhythm
HV - not done
Photic - no effect

Clinical Interpretation:
Frequent right occipital spikes suggest seizure origin from that area. Background slowing in the posterior head could reflect recent seizure activity, but a mild generalized encephalopathy cannot be ruled out. A follow up recording would be of interest in that regard.


If someone can help me understand what this means it would be greatly appreciated.
 

Nakamova

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Hey Bookie123, welcome to CWE!

I'm sorry you are facing this; it's not easy to see your kid seize, and it would be great if the neuro appointment could be immediate. But there are reasons why it's better to wait for the neuro's evaluation. There will be information and context in the report the neuro sees that aren't listed in the basic results listed above. Details like the age of your daughter and whether she was awake or asleep during any of the EEG are important, and also things like the pattern of the spikes and how they appeared against any background waves. Plus the kind of seizures she's been having.

The most basic reading of this test: The EEG, combined with the clinical stuff (her actual seizures) suggests fairly strongly that she has a seizure disorder.

Some very general things you can take away from the results:
Dysrhythmia grade IV right occipital posterior temporal spikes =
Dysrhythmia just means abnormal brainwaves. They can be caused by all sorts of things, including anxiety. They are graded on a scale of I to IV. Any "grades" can be indicative of a seizure disorder, including grade I, and the presence of spikes does suggest epilepsy. Grade IV doesn't mean more severe, just more suggestive of epilepsy.

Right occipital posterior temporal spikes = the region of the brain where the abnormal brainwaves are originating. Again, spikes tends to suggest epilepsy.

Delta Grade II Bioccipital= Refers to certain brainwaves associated with sleeping adults or awake babies. It can be associated with mild encephalopathy or epilepsy. In this case the brainwaves are appearing on both sides of the head ("bioccipital".)

Encephalopathy = a loose, non-specific term meaning the brain not behaving properly. There are all different varieties and causes -- diseases, bacteria, viruses, environmental toxins, metabolic issues -- but the EEG suggests that it's more likely that the docs will rule it out rather than in as a diagnosis.

EKG - Sinus rhythm = Normal beating of the heart.

HV - not done
Photic - no effect
The hyperventilation (hv) and photic tests are often done to see if they are triggers for increased spike activity characteristic of epilepsy. For whatever reason (age of your daughter?) they didn't do the hyperventilation test ("not done"). The photic test uses strobe lights flashed the person's eyes. It looks like your daughter isn't photosensitive ("no effect"). This test is a trigger in about 5-10% of people. Sometimes it's associated with brainwaves characteristic of absence seizures.

I hope this helps a little bit. Make sure to write down all the questions you have for the neuro to bring into the appointment. If possible, write down all the answers too, or have someone with you at the appointment who can do so. Don't leave the appointment if anything seems unclear, and make sure you know how to get in touch with the neuro if you have more questions.

Hang in there.

:hugs:
 

masterjen

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Hi, and welcome to the forums. It is nice to see a fellow Canadian here :)
I'm afraid I cannot clarify the EEG report, but there are a few folks here who may have enough knowledge to offer input.
Is your daughter on medication? What are her seizures like?
Best of luck to you, and keep us posted on what the neurologist says at her appointment.
 

Bookie123

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About my child

She is 5 years old(dec/14) the seizures started when she was 4(nov/14). She has at least 2 episodes a day and God knows how many she has when she is sleeping I've witnessed at least 5 some nights. She has tonic clonics and focals. Some times she comes out of the seizures in seconds sometimes it takes almost an hour. She has seizures when she is extremely upset or extremely energetic but mostly in her sleep. She has troubles sleeping as well now. She is scared to be left alone. She twitches alot and grinds her teeth. She has a history of kidney obstruction as well. She also has history with utis and ear infections which have been taken control of with surgery to insert tubes in her ears and the utis are under supervision by a urologist. She has had episodes where she is doing something and you turn around and she is passed right out and you can not wake her up but does not follow convulsions. She slept through her eeg!
 

Nakamova

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Is she on any anti-seizure or other medications, while awaiting the neuro's diagnosis?
 

Nakamova

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One more thing -- has your daughter been tested for any metabolic syndromes? There may be a link between the kidney disorders and the seizures if there's an underlying metabolic issue like hypercalciuria (which can cause both).
 

Bookie123

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She is not currently on any medication and has not been tested for metabolic issues because her urologist does not think they are linked. Originally I thought they were linked because her kidney was extremely swollen and wasn't draining when the seizures started. I will have to look into this further! Thank you
 
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