Shannon Higgins a special girl born with Polymicrogyria (PMG)

EEG Report 1999
 

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KAISER PERMANENTE
EEG REPORT
KPMG OAKLAND

RE: HIGGINS, Shannon
MR# 09762169
REASON FOR EEG: Polymicrogyria rule out possible seizures.
REFERRING MD: A.G.Taniguchi, M.D. John Cassidy, M.D./Pediatric Neurology in Santa Rosa.
DATE OF EXAM: 6/16/99.
TEGJ 61345
MEDICATIONS: None.

REPORT OF ELECTROENCEPHALOGRAM: The tracing opens and the background consists of relatively well organized 4 to 5 hertz activity. This is displayed over the posterior aspects and does attenuate appropriately with eye opening. The patient rapidly becomes drowsy and sleep is recorded. During sleep synchronous and asynchronous sleep spindles were noted from the vertex in accompaniment with vertex waves. As the patient proceeds with stage II sleep, sharp and slow foci are noted from the posterior quadrants, left more so than the right. These occur independently. on rare occasions runs of the sharp and slow foci are noted briefly for a few seconds.

IMPRESSION: This is an abnormal tracing because of epileptic type foci seen from the posterior quadrant, left greater than right, during sleep.

/s/
Jean Hayward, M.D
Pediatric Neurology at Oakland

DT: June 17, 1999
Pediatric Neurology-Kaiser Oakland (dictated but not read)
90233 (11-91)

EEG report and translation

Question to Child Neurology Webforum at Massachusettes General Hospital on 18-Jan-00

I got a hold of a report that had a bit of stuff about my daughter's eeg taken last summer. The doctor interpreted it as showing "occipital epileptiform discharges without electographic seizures or other abnormality." She has not had clinical seizures. Can someone translate this into layman's terms. She is 18 months old and has polymicrogyria. We're told she is at high risk for seizures although she hasn't had any yet (knock on wood). Thanks in advance.

Response from Digger on 1/18/00

Hi Mary... Your daughter's EEG is probably showing interictal epileptiform activity....abnormal electrical discharges in the brain that have the potential to cause seizures...and happily haven't yet :-). "without electrographic seizures" mean that there were no actual seizures recorded...just the spikes showing seizure potential. The occipital region of the brain is on the back of the head, and is primarily responsible for visual processing...so regular eye exams may also be important...

Best of luck with you daughter....

------------------
Šigger

Response from Scientist Bill on 1/19/00

Just to clarify what Digger said. When he ways eye exams, he means more than just your normal tests of visual acuity. If there are abnormal discharges in that area of the brain, you should be alert for any indication that she is "seeing things", like flashes of light. An occasionally, a test of visual field (making sure she can see things at all locations on the retina) probably would be a good idea. Your neurologist can recommend what you need better than I.

I would also pester them about whether they used a strobe light during the EEG and whether it caused any abnormal discharges. Should do with anything abnormal in the occipital area of the brain.

But as Digger said, so far so good.

Reply from Mary on 1/19/00

I'm a bit confused about there being suspicious activity in the occipital area. She has been tested for sight and has normal vision with a bit of far-sightedness which he said was normal for young children. Otherwise, she makes excellent eye contact and tracks constantly. She does do a lot of blinking when objects are put close to her face and when she hears loud sounds. I will talk with her pediatrician about exploring what that all means for Shannon. Thanks again for your input.