What Does This Electroencephalogram Report Indicate?

Posted on Thu, 29 Dec 2016

Question: Hi there i am following up on my previous question. I have the eeg report for my son.

I have attached the eeg report.

Hi he had a psychical done recently. Red eye reflex normal, Babinski reflex normal. He is doing very well in school. The report mentions structural or functional issues (possibly). What does all this mean. I am so worried. Is he going to die, is he going to be retarded. Please help me understand.

Sorry just in case you need the info, this is a follow up for my question submitted Nov.17th 2016.

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
Childhood seizures without other cause still possible.

Detailed Answer:
Hello again and thanks for being on follow up with me.

I examined the EEG report of your son's.

The report states that there are abnormal discharges only on the left hemisphere, and mainly posterior that corresponds to the occipital lobe mainly, anatomically speaking.

So, again, Panayiotopulos syndrome still stands as a possible condition.

But this doesn't mean that your son is going to die, imaging studies such brain MRI are necessary to evaluate and exclude other possible conditions such vascular malformations for example.

In cases of epilepsies, it is always necessary for cognitive function follow up because seizures itself may cause such decline over the time.

Since your son is doing well and there were no abnormal findings in medical examination, I think you shouldn't worry much more than necessary.

Please get a brain MRI done and continue following up with your son's Doctor.

Hope this helps. Do let me know if you've any further doubts

Kind regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Erion Spaho (22 hours later)

Thank you Doctor. I'm trying to stay calm. This all started for my son after his grandfather died. 3.5 weeks after his death he had is first seizure. Can stress be a trigger? He was very close to him.

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
Stress may trigger seizures, but doesn't cause them.

Detailed Answer:
Hello again.

Stress is one of the most prominent causes of triggering factor for a seizure, but can't cause seizures without any organic etiology.

Trying to stay calm is the best thing for you and your son.

Hope I helped you so far, feel free to ask further.

Wishing you and your son good health.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Erion Spaho (3 days later)

Thanks again doctor. The MRI has been ordered. One more question, i read about LGS, is there any likely hood that he has this? I do see that some the of the symptoms are frequent seizures, which he does not have, and behavioral, development issues, which again he does not have. Only the abnormal eeg. Again sorry to bother you, i will not ask another question after this.

Answered by Dr. Dr. Erion Spaho (6 hours later)

Brief Answer:
LGS is unlikely.

Detailed Answer:
Hello again.

First of all, you can ask as many questions as you need, we are here to help you.

MRI is a necessary tool in achieving a correct diagnosis in such cases.

Lenox-Gastaut syndrome is unlikely regarding to your son's symptoms, however it cannot be excluded entirely.

Mental retardation or regression is a common feature of LGS.

EEG findings also support more Panayiotopulos syndrome than LGS.

Hope I helped you.

Wishing good health to you and your son.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Erion Spaho (47 hours later)

Thank you doctor. We did meet with our son's doctor today and he advised us of the following. My sons is show CSWS with sleep spikes around 50%. To ensure that the spikes do not go to 85% or up he is advising us to medicate with clobazam. He did not seem to concerned with the seizures because they were not frequent. He said that the CSWS should clear up in a few years. Is a CSWS at 50% way above normal or borderline?

Can this be Epilepsy with electrical status epilepticus during slow-wave sleep? the eeg did not mention this.

sorry just to clarify his spike wave index is at around 50%

Answered by Dr. Dr. Erion Spaho (10 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again and thanks for being on follow up.

Spikes wave index should be about 85%, in order to diagnose CSWS.

In my opinion, it is not electrical status epilepticus, because of insufficient support from EEG findings and absence of development/behavior issues.

MRI is still necessary.

Hope this helps.

Kind regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Erion Spaho (6 hours later)

Thank you Doctor. If the MRI comes back clean, which my son's doctor thinks it will, should we still put him on medication? what are the chances of the spikes jumping up to 85%. Will the medicine actually work and lower the spikes.

Answered by Dr. Dr. Erion Spaho (8 hours later)

Brief Answer:
Treatment aims to prevent seizures.

Detailed Answer:
Welcome back.

The treatment aims to prevent seizures and eventually will lower abnormal spikes.

I think too, that MRI will result normal, however, if any brain involvement such encephalopathy will be noticed, in such case there is a possibility that spikes and wave index to jump to 85%.

Hope this helps.

Kind regards.

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Above answer was peer-reviewed by : Dr. Arnab Banerjee