August 24, 2022 "EEG Results"

Dr. Lewis reported that Rayden's 24 hour EEG showed abnormal discharges occurring in multiple parts in the central regions of his brain (both sides=generalized seizures). The discharges were very frequent during sleep. They do not completely correspond with the area of the hippocampus, which was smaller (atrophic) on the MRI. After talking with the epileptologist, Dr. Lewis said the abnormal discharges are frequent, but not dangerous. Discharges do not cause damage to the brain, but ongoing seizures do. Since the discharges occur on both sides, the plan is to continue trying to prevent seizures with anti-seizure medication. 

The official report from UNC is difficult to understand but it is as follows: 

TECHNICAL DESCRIPTION:

AWAKE STATE: The dominant posterior rhythm is a medium amplitude 6-7 Hz activity with good reactivity. The background is comprised of predominantly mixed frequency theta, alpha and beta range frequencies.

SLEEP STATE: The patient cycles through sleep, sleep elements are well developed and symmetric

INTERICTAL DISCHARGES: Occasional awake state sharp waves over central (C3, C4) and temporal (T7, T8) head regions.

Discharges greatly increased in sleep, frequent to abundant discharges, right and left central, temporal, and central-temporal. (C3, C4, T7, T8)

 

IMPRESSION:

Abnormal 24 hours ambulatory EEG

-- mild diffuse background slowing

-- frequent sleep potentiated multifocal sharp waves over parasagittal central and temporal head regions (C3, C4, T7, T8)

 

CLINICAL INTERPRETATION

Background activity in this study is indicative of bi-hemispheric dysfunction of non-specific etiology, it may be seen on the basis of toxic, metabolic or primary neuronal dysfunction.

Epileptiform activity seen in this study is consistent with multifocal cortical irritability, and similar to that seen in patients with epilepsy of multifocal mechanism of onset.

When seizures appear to result from abnormal activity in just one area of your brain, they're called focal seizures. Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. 

• Absence seizures. Absence seizures, previously known as petit mal seizures, typically occur in children. They're characterized by staring into space with or without subtle body movements such as eye blinking or lip smacking and only last between 5-10 seconds. These seizures may occur in clusters, happening as often as 100 times per day, and cause a brief loss of awareness.
• Tonic seizures. Tonic seizures cause stiff muscles and may affect consciousness. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground.
• Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control. Since this most often affects the legs, it often causes you to suddenly collapse or fall down.
• Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms.
• Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches and usually affect the upper body, arms and legs.
• Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure. They can cause an abrupt loss of consciousness and body stiffening, twitching and shaking. They sometimes cause loss of bladder control or biting your tongue.