Neurologist said she doesn't think son is having seizures, but should get EEG anyway

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also - almost all kids with epilepsy have adhd.

Person with epilepsy here. Have never ever heard this.

Agree that makes no sense and if kids are having seizures which are impacting their functioning, that wouldn't be adhd but seizure.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also - almost all kids with epilepsy have adhd.

Person with epilepsy here. Have never ever heard this.

I will post some studies for you - its like 80% for children.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also - almost all kids with epilepsy have adhd.

Person with epilepsy here. Have never ever heard this.

Agree that makes no sense and if kids are having seizures which are impacting their functioning, that wouldn't be adhd but seizure.

Yeah, the brain does not work like that. It actually makes complete sense, given that ADHD is often misfirings or brain damage. Those are the same things that cause seizures. Its an abnormal brain. ADHD and epilepsy are neurological.

[Anonymous]

The risk of having ADHD if you have epilepsy is up to 3x higher in some studies, as discussed here:

https://consumer.healthday.com/cognitive-health-information-26/epilepsy-news-235/epilepsy-may-triple-adhd-risk-712815.html

[Anonymous]

OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also - almost all kids with epilepsy have adhd.

Person with epilepsy here. Have never ever heard this.

Agree that makes no sense and if kids are having seizures which are impacting their functioning, that wouldn't be adhd but seizure.

Yeah, the brain does not work like that. It actually makes complete sense, given that ADHD is often misfirings or brain damage. Those are the same things that cause seizures. Its an abnormal brain. ADHD and epilepsy are neurological.

Got cut off accidentally - they can, of course, be comorbid.

[Anonymous]

I think we're getting a little far afield here. The question is whether OP should get a fairly involved, expensive, and time-consuming procedure (EEG) just to "rule out" seizures, when a neurologist has seen no clinical indicia of the kind of seizures that might be occurring.

I think that OP would be completely reasonable to turn it down. First of all, I don't think that EEGs for ADHD are at all the standard practice. Second of all, it's also not standard practice to do an EEG before prescribing a stimulant med for ADHD.

It seems like OP's neurologist is just in the frame of mind of "gather more information just in case." That's all fine and well, but it also comes with costs. (False positives, time, money, stress, anxiety, sleep deprivation.)

IF OP's child does have a seizure disorder, it will make itself known by clearer signs - and she can do all the testing then.

[Anonymous]

Anonymous wrote:I think we're getting a little far afield here. The question is whether OP should get a fairly involved, expensive, and time-consuming procedure (EEG) just to "rule out" seizures, when a neurologist has seen no clinical indicia of the kind of seizures that might be occurring.

I think that OP would be completely reasonable to turn it down. First of all, I don't think that EEGs for ADHD are at all the standard practice. Second of all, it's also not standard practice to do an EEG before prescribing a stimulant med for ADHD.

It seems like OP's neurologist is just in the frame of mind of "gather more information just in case." That's all fine and well, but it also comes with costs. (False positives, time, money, stress, anxiety, sleep deprivation.)

IF OP's child does have a seizure disorder, it will make itself known by clearer signs - and she can do all the testing then.

Forgot to add -- OP can have a careful conversation with the neurologist about this to suss out whether the neurologist in fact has additional concerns. The neurologist ought to be able to explain his reasoning, and weigh in on what he thinks of choosing to skip the EEG.

[Anonymous]

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

This may be true -- however, not all kids with ADHD have epilepsy, and it is not standard practice to screen all kids with ADHD with an EEG for no other reason than the ADHD!

[Anonymous]

Anonymous wrote:

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

This may be true -- however, not all kids with ADHD have epilepsy, and it is not standard practice to screen all kids with ADHD with an EEG for no other reason than the ADHD!

Nope. But it does explain why you can't not worry about it being absence seizures because there is also ADHD. I think it would be ridiculous if the school has mentioned zoning out to avoid doing an eeg. Why would you run that risk?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

This may be true -- however, not all kids with ADHD have epilepsy, and it is not standard practice to screen all kids with ADHD with an EEG for no other reason than the ADHD!

Nope. But it does explain why you can't not worry about it being absence seizures because there is also ADHD. I think it would be ridiculous if the school has mentioned zoning out to avoid doing an eeg. Why would you run that risk?

It's precisely because there just isn't a big risk here. The neurologist sees no clinical signs of absence seizures. More screenings and tests are not always a good thing. That's what I would recommend another convo with the neurologist to discuss exactly what she things the EEG is going to show, and what she would think about skipping it. She may very well say "That's fine to skip it, just covering all the bases. Come back in six months or if anything else happens." Or, she may have a clearer rationale for why she recommends an EEG.

[Anonymous]

Op again - The neurologist said she doesn't see any signs of seizures, but suggested getting an EEG so that we have a the full overall picture of his diagnoses/issues. As pp said "covering all the bases." And then she mentioned the medication thing.
He has already met his deductible this year, so if there is a time to do it, I suppose it would be now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

This may be true -- however, not all kids with ADHD have epilepsy, and it is not standard practice to screen all kids with ADHD with an EEG for no other reason than the ADHD!

Nope. But it does explain why you can't not worry about it being absence seizures because there is also ADHD. I think it would be ridiculous if the school has mentioned zoning out to avoid doing an eeg. Why would you run that risk?

It's precisely because there just isn't a big risk here. The neurologist sees no clinical signs of absence seizures. More screenings and tests are not always a good thing. That's what I would recommend another convo with the neurologist to discuss exactly what she things the EEG is going to show, and what she would think about skipping it. She may very well say "That's fine to skip it, just covering all the bases. Come back in six months or if anything else happens." Or, she may have a clearer rationale for why she recommends an EEG.

I completely disagree with your risk analysis. This is precisely when you are supposed to test for absence seizures - when you suspect ADHD and there is zoning out!! http://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/absence_seizures_134,16/

Also, what you are failing to account for is the enormous potential damage to the brain posed by unmitigated seizure activity. Here, low risk of seizures must be weighed against the very high risk posed by not ruling them out.

[Anonymous]

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

Many people with cerebral palsy also have epilepsy. I believe it's also 80%. I think you are really failing to see the forest for the trees.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OK - I poked around and apparently it is 80% for kids that have the type of epilespy my son has, and around 30-40% for other kinds. So much higher - well, three to four times higher, as noted in the study discussed above - on average. Point being that they often go hand in hand, and many kids that are medicated for epilepsy are also taking ADHD meds.

This may be true -- however, not all kids with ADHD have epilepsy, and it is not standard practice to screen all kids with ADHD with an EEG for no other reason than the ADHD!

Nope. But it does explain why you can't not worry about it being absence seizures because there is also ADHD. I think it would be ridiculous if the school has mentioned zoning out to avoid doing an eeg. Why would you run that risk?

It's precisely because there just isn't a big risk here. The neurologist sees no clinical signs of absence seizures. More screenings and tests are not always a good thing. That's what I would recommend another convo with the neurologist to discuss exactly what she things the EEG is going to show, and what she would think about skipping it. She may very well say "That's fine to skip it, just covering all the bases. Come back in six months or if anything else happens." Or, she may have a clearer rationale for why she recommends an EEG.

I completely disagree with your risk analysis. This is precisely when you are supposed to test for absence seizures - when you suspect ADHD and there is zoning out!! http://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/absence_seizures_134,16/

Also, what you are failing to account for is the enormous potential damage to the brain posed by unmitigated seizure activity. Here, low risk of seizures must be weighed against the very high risk posed by not ruling them out.

If every kid who had suspected ADHD and zoned out got an EEG, that would be an enormous waste of resources. And the neuro has already said that the zoning out doesn't seem to be absence seizures.

Also, I think you have a mistaken understanding of epilepsy and seizures. Seizures do not cause "enormous potential damage" in and of themselves, although they may be a symptom of damage that exists. Delaying treatment for epilepsy does not worsen the condition or affect long term remission, according to current thinking. You treat epilepsy to treat the seizures; it's not something like taking antibiotics where you need to take the meds right away to keep it from getting worse. The exception is something like Landau-Kleffner where early treatment can help developmental progress. But there's no evidence of that here.

I would skip the EEG here myself unless the neurologist saw something *clinically* that made her want to investigate more, not just a desire to rule everything possible out.