Daughter's EEG

[klmom]

I apologize in advance if I add too much to this post that is unnecessary, but I am unsure what is important in helping us figure out what this could be.

Last week, I got a phone call from the clinic at my daughter's (she is 11) school stating that she was complaining of nausea and a bad headache. After I picked her up, she said that it hurt pretty bad over her right eye and that she had felt some sort of 'out of body experience' prior to my getting to the school to pick her up. She wasn't in a full blown 'slurring' of her words, but her speech was a little more difficult for me to understand — almost like she was too tired to speak which is what she told me, that she was very tired and just wanted to get to bed. By the time we arrived home, her nausea turned into emesis (the nice word for what happened). She could have just had a stomach virus, but something felt all wrong to me especially since she had similar symptoms a couple of months ago during our spring vacation and then again a month ago just not as bad and several times before that. I took her to the Doctor within an hour of picking her up from school where the emesis continued. After hearing the symptoms and witnessing some of them, the Doctor sent my daughter to All Children's Hospital in St. Pete, FL for an EEG and a CT scan. The CT scan came back normal. There was some sort of size difference, but it was written as within normal range. A few days later the EEG came back not so normal. Apparently, after their induced hyperventilation, Katie had some reactions they consider significant somehow. We have yet to speak to a neurologist so we don't know for certain what the 'abnormalities' in the EEG mean and we are extremely worried. Here is what it says:

Waking posterior background demonstrates alpha activity, which is symmetric over both hemispheres. The anterior regions demonstrate a mixture of slow wave freqencies which are also symmetric. Photic stimulation is performed and provokes no abnormal discharges. During hyperventilation high amplitude slowing sometimes of a sharp contour seem to occur in an asymmetric fashion. Residual left frontotemporal slowing is seen to be present for a period after the hyperventilation. Infrequent vertex waves are seen to be present symmetrically over both hemispheres. There are no epileptiform discharges. There were no clinical events. There were no subclinical seizures.

Impression: Abnormal EEG recording because of intermittent slowing in the left frontotemporal region with asymmetry during hyperventilation with accentuation of this asymmetry.

and

Clinical Correlation: This EEG is suggestive of a nearly focal cerebral dysfunction of nonspecific etiology. This may be an indication of an underlying structural or functional process. Clinical correlation is recommended.

Bottom line is since we have read up on some of what this says, we are concerned this could be a lesion or growth of some sort. What else could this be along with the symptoms. Thank you so much for your time and help!

[clinicalguru3]

Thanks for the question.

According to the information you sent the following possibilities exist:-

1) The EEG is a red herring...such "abnormalities" are possible even in people without neurological problems and in such a case it could be that the episode was related to the process of migraine.

2) The EEG showed a subtle abnormality which is real...this does not mean that there would necessarily be something physical to "see" on an MRI, but may show that there is an "irritable" area of the brain that may need some medical treatment.

Because no. 2 is a possibility it would be common in this situation to be on the safe side and perform an MRI..I would also repeat the EEG including a longer sleep deprived and sleep study to see whether the finding returns or is clearer.

Hope that helps and please update us!

[klmom]

Thank you so much for your reply! That is what I needed to hear — that there were other possibilities other than what 'Google' searches were providing which sounded like the there were only a few options. ...that could also be because I am not versed very well in neurological terminology.

She did end up having an MRI this past Friday. We do not have the results yet, but I will post them here as soon as we receive them. It was not the neurologist who ordered the MRI, rather her pediatrician because she figured the neurologist would do so anyway. This way he will have it for the appointment.

We have an appointment with the neurologist on the 25th and it is good to know in advance what further tests he may order such as the sleep deprived EEG and the sleep study. It is relieving also to have an idea before we get to the appointment what the neurologist may be looking for and why. This will save an immense amount of time placing us all on the same page at the beginning.

I truly appreciate your time and help and will update any further findings as soon as we get them!

Thanks again!!

Very Respectfully,

Kristi

[Dr_prakesh]

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