EEG results

His EEG showed some interesting things. It's still very abnormal, which is no surprise. But, it looks like he has more discharges while sleeping, which was a bit of a surprise to us. We've never seen a seizure at night.
The big news is that it looks like there might actually be a focal point!! He's had quite a few EEG's, and this is the first that showed any indication of any focal point. Of course a focal point is really big news, because if you can clearly identify the exact focal point, it's possible to actually go in and remove that part of the brain. But, that's a long way off and we don't want to get ahead of ourselves. We're hoping that they might be willing to do further testing, though.

Here's the full text of the EEG report:

Introduction: This is a routine electroencephalogram performed on a 5-year-old with history of seizures since age 2, which have significantly improved with vagus nerve stimulation [note: not true, it was the Keppra!]. Last seizure was reported May 2007. Medications include Keppra and Felbatol. The standard 10-20 system of electrode placement was used with one channel of EKG monitoring.

Description of the record: During periods of relaxed wakefulness, there is a posterior dominant rhythm which consists predominantly of 7Hz activity of moderate amplitude, with lower amplitude faster frequencies present symmetrically in the anterior head regions. Reactivity to eye opening/closure is not demonstrated.

Although waking background is somewhat obscured by muscle artifact particularly in the frontal regions, only rare to occasional sharp and slow wave discharges are seen with phase reversal at FP1. These appear to increase in frequency as likely drowsiness is entered, suggested by decrease in movement and muscle artifact.

During sleep, these discharges occur frequently. Although at times they are near-continuous, occurring at 1 to 2 hertz, there are usually several seconds in which no discharges are noted. At times there is a broad field to these discharges, spreading to the left temporal and central regions.

Vortex sharp waves and spindle activity of sleep are seen.

EKG shows normal sinus rhythm throughout the recording.

Impression: This is an abnormal EEG for age recording wakefulness through stage II sleep due to mild diffuse background slowing, and left frontopolar epileptiform discharges which increase with sleep.

Clinical Correlation: The diffuse background slowing suggests diffuse cerebral dysfunction, though not specific as to etiology. The left frontopolar epileptiform discharges suggest a focal and possibly rapid secondarily-generalized mechanism of onset to the patients seizures.