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Epilepsy

2nd EEG varied from the original EEG

03/09/2010

Question:

My child`s first EEG stated: mulitple right cetnral sharp waves and generalized spike wave and polyspike wave discharges precipitated by the right central hemisphere spikes. Findings are best correlated with benign central/temporal epilepsy.

Dr. put my child on 300 mg. of lamictal (of course was tiered to that dose and was on for approx. 4 mo) he suspected that meds weren`t working so we did another EEG

2nd findings said: intermittent focal slowing over the left hemisphere, indicating possible underlying structural abnormality, as well as bilateral indipendent epiliptiform discharge in the temporal region.

Question: How can the seizures move from the right to the left side? Can you give me an explanation as to understand the two EEG`s and if Lamictal could actually cause more seizures or for them to change?

Dr. is weening us off of Lamictal and starting on Trileptal.

Thank you for any answers you can give.

Answer:

The good news is the EEG is suggestive of benign centro-temporal epilepsy, which resolves in the great majority of cases after a few years. The EEG is limited because it is only 20 minutes and spikes can vary in frequency over the day, so that a "different" EEG may only be a sampling problem. If your child truly has Benign centro-temporal epilepsy, most kids with this disorder have bilateral independent spikes (as seen in the second EEG), so they would likely have been seen with a longer EEG recording. No need to worry, the lamictal almost certainly did not make the EEG worse. Good luck.

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Response by:

Michael   Privitera, MD Michael Privitera, MD
Professor of Neurology
College of Medicine
University of Cincinnati