Abnomal EEG with normal MRI in child

[luciatrinh]

Is my neurologist being too aggressive? My son is 3 years old and had two seizures while having a fever. Seizures were considered atypical for febrile seizures so they did an MRI (normal results), a blood test (normal results) and an EEG (abnormal). The EEG impressions read as follows "Abnormal record due to paroxysmal activity, noted in a diffuse distribution, consisting of spike and high voltage 2.5-3 cycles per second spike and wave activity, admixed with multispikes, markedly accentuated in sleep, but noted as well in the drowsy portion of the record. The record is highly suggestive of a diffuse convulsive disorder, particulary of the myoclonic variety." In the results, it also says that there is "rarely during the periods of drowsiness, high voltage spike activity is noted in a diffuse distribution, accentuated in the right central region. During sleep, fairly frequent high voltage 2-3 cycles per second burst are noted, admixed with spike and spike and wave activity as well asmultispike activity in runs lasting upwards of 3 seconds. Again, there is some emphasis of multispike activity in the right central region."
My neurologist recommended Keppra, 1 ml/twice a day for the first two weeks, then 2 ml/twice a day for at least 12 months, until the next EEG (12 months from now). He said to keep him on the medication until there is a normal EEG. But I read EEGs are not that reliable and considering MRI was normal and no seizures at all since June (no fevers either), and family history (my brother and I had seizures up to 2 years old), should he really be on Keppra or any medication? Don't the possible side effects outweigh the benefits? He said if we leave it untreated he most likely will have another seizure and that treating seizures later on will be harder. I am also concerned about considering EEG the only tool to justify treatment or outgrowing the seizure disorder. I have more detailed EEG results if you need them.

[MG (Admin)]

But I read EEGs are not that reliable and considering MRI was normal

Where did you read this!
An EEG can detect seizure activity...an MRI cannot!

If according to the treating neurologist your child is at risk of having seizures (previous seizures and an "epileptic" EEG suggest this) then the benefits of anti-epileptic medication out-weigh the possible side effects.