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EEG Results - My poor brains - and do you still think I'm attention whoring and faking?

I got the first wave of bills from my health insurer yesterday for my vacation in the neurology unit at my hospital.  We have a 90/10 plan, so, yeah... seven days.  That's a lot of money.  While I left the hospital and immediately enjoyed 15 days seizure-free on new medication, the seizures came BACK.  I am now back in my regular pattern of complex partial seizures every 3-7 days, including this morning at 6am.  "Yay."

I just emailed my neurologist to let him know, when I noted that my EEG results were online.  I suppose you will believe me NOW?

 What follows is the EEG translation of the grand mal seizure I had on the first day of my inpatient video EEG --

"FINDINGS: 

ROUTINE SAMPLING: The background consisted mostly of an 8 Hz alpha
frequency activity with prominent right frontal temporal theta and delta
frequency slowing, particularly in drowsiness and in sleep. Interictal
discharges were also seen in the right frontal temporal region as
described under Spike Detection programs.

SPIKE DETECTION FILES: There were 412 spike detections recorded, almost
all of which were for moderate to high amplitude, spike and wave or
sharp and slow wave discharges in the right frontal temporal region
phase reversing at F8 or isoelectric at F10-T10.

SEIZURE DETECTION FILES: There were 41 seizure detections for bursts of
waking background frequencies in the 10 Hz range. Focal right temporal,
mixed theta and delta frequency slowing was seen persistently throughout
the record, particularly in drowsiness and sleep.

PUSHBUTTON EVENTS: There were three pushbutton activations for the same
seizure. Prior to the pushbutton, the patient was in stage II sleep
with prominent right temporal theta and delta frequency slowing
04:51:22, low amplitude beta frequency activity could be seen starting
in the right temporal region followed by diffuse muscle artifact during
the record, and by 04:51:38, moderate amplitude sharp theta frequency
activity could be seen diffusely in the right temporal chain and
subtemporal chain with continued evolution in both frequency and
amplitude. Some of this activity was reflected in the right frontal
region as by 04:51:58, diffuse fast sharp activity is seen in the entire
EEG record and by 4:52:20 high frequency generalized activity obscured
the entire EEG. The discharges started to slow down and eventually end
by 04:53:16. On video, the patient was lying supine in bed with head
turned to the left, asleep, and the clinical features started within a
few seconds after fast right temporal beta activity was noted, first
with deep breathing and slight increase in heart rate. The patient
then turned her head to the midline and the left hand extended. At this
point, mouth movements and bilateral hand automatisms were seen as she
rubbed the right leg with the right hand and the left hand elevated.
She then turned her head to the right slightly and started to play with
the bed sheet with the right hand. Eyelid fluttering and lip smacking
were also seen. Both hands started to move from side-to-side followed by
right arm extension and the left hand start patting right arm. At this
point, her gaze was slightly to the right, followed by head extension,
tonic right arm flexion, right head deviation and facial contraction.
As the seizure generalizes, she has forced head extension, bilateral arm
flexion, left head deviation, mouth opening and left facial contraction,
and tonic extension of the left arm. Clonic movements of all four
extremities were then seen until the end of the seizure.

SLEEP: The patient progressed from wakefulness to various stages of
sleep with activation of the discharges and focal slowing in the right
frontal temporal region, as described above.

CARDIAC MONITOR: Showed a generally regular rhythm of 72 bpm.

IMPRESSION: This is an abnormal video EEG due to the presence of a
clinical and electrographic seizure that began in the right frontal
temporal region with secondary generalization.

Clinically, the seizure was characterized by awakening from stage II sleep, oral and bilateral hand automatisms, eyelid fluttering, followed by left head and eye
deviation, and secondary generalization.

The seizure lasted just under two minutes. Interictally, spike and wave or sharp and slow wave discharges were seen in the right frontal temporal region, phase
reversing at F8 or isoelectric at F10-T10, indicative of an active
epileptogenic focus. Persistent focal slowing in the right frontal
temporal region was also seen during sleep indicative of underlying
subcortical dysfunction. The waking background otherwise reached alpha
frequency.


OBJECT: EE,INPT LTM W/Video,EKG,5/4-5/5/12.

The other 'non-seizure' days looked like this -

ROUTINE SAMPLING: The background consisted mostly of a 9 Hz alpha
frequency activity with prominent and prolonged runs of right frontal
temporal theta and delta frequency slowing, particularly in drowsiness
and in sleep. During wakefulness, rhythmic 7 Hz activity could be seen
in the right posterior temporal region, as well. There were also
infrequent bursts of theta frequency slowing in the left temporal
region. Interictal discharges were also seen in the right frontal
temporal region as described under Spike Detection Programs.


SPIKE DETECTION FILES: There were 417 spike detections recorded, almost
all of which were for moderate to high amplitude, spike and wave or
sharp and slow wave discharges in the right frontal temporal region,
phase reversing at F8 and isoelectric at F10-T10. Very infrequently
seen were low amplitude sharp wave discharges seen in the left temporal
region, isoelectric at F7-T3.

SEIZURE DETECTION FILES: There were 40 seizure detections, many of
which reflected rhythmic sharply contoured theta frequency activity in
the temporal regions bilaterally, synchronously or independently, R>L.
Other files revealed prolonged runs of mixed theta and delta frequency
right temporal region, particularly during drowsiness and sleep.

PUSHBUTTON EVENTS: There was a single activation for disconnection and
reconnection at 11 a.m.

SLEEP: The patient progressed from wakefulness to various stages of
sleep with activation of the discharges and focal slowing in the right
frontal temporal region and left temporal region, as described above.

CARDIAC MONITOR: Showed a generally regular rhythm of 72 bpm.

IMPRESSION: This is an abnormal video EEG due to the presence of
interictal spike and wave or sharp and slow wave discharges seen in the
right frontal temporal region, phase reversing at F8 and isoelectric at
F10-T10, indicative of an active epileptogenic focus. Infrequently seen
were also broad-based low amplitude sharp waves in the left temporal
region, isoelectric at F7-T3, indicative of a separate area of potential
epileptogenic focus.

Persistent and prolonged runs a focal slowing in
the right frontal temporal region and infrequent shorter bursts of
theta frequency slowing was seen in the left temporal region, indicative
of underlying subcortical dysfunction in these regions. The waking
background otherwise reached normal alpha frequency. No electrographic
seizures were seen.


OBJECT: EE,INPT LTM W/Video,EKG,5/8-5/9/12.

Well, heck.  I'm having focal slowing at an average of twice an hour - no wonder my brain is mush most of the time.

Do you believe me yet?

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