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

Forum Index » Kids With Special Needs and Disabilities

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

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=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.[/quote]

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![/quote]

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. [b]Why would you run that risk[/b]? [/quote]

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. [/quote]

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. [/quote]

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 t[b]hink 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. [/b] 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.

[/quote]

Not all neurologists agree on this. Ours does not. We saw spiking, not seizures, on the EEG, and my son does not have a syndrome as far as we know. But we have seen major improvements in behavior, speech, and focus, since medicating, and by no means are we alone. There is definitely controversy about treating sub clinical seizures or whether undetected seizures cause brain damage, despite your assertion. It is, as you noted often a sign of damage, but unmitigated seizure activity, or seizure activity that is not responsive to treatment, has most definitely been associated with much pooer cognitive outcomes. Because simply not that much is known at this time, doctors do not know if this is a chicken or an egg issue -is it because of a damaged brain or does prolonged unchecked seizure activity led to brain damage. Regardless, one of the reasons you medicate, according to our pedioatric neuologist, is to train the brain not to seize. I simply can't imagine not ruling out such a serious issue if it was suggested by the school and the neuro thought it prudent. Also, how on earth would the nuero see signs of absence seizures in a clinic appointment? They are hard even to spot on a regular EEG. There is no way they can be ruled out in a office visit. [/quote]

I agree with you that treating seizures can improve learning, behavior, and thus short-term cognitive outcomes.  I don't think it would be unreasonable for OP to get the EEG.  But schools don't diagnose absence seizures, and there were no clinical signs.  (Absence seizures can be tested for by the hyperventilation test, which was negative here.)  Without more indications of seizures, I think skipping the EEG is a totally reasonable course of action.  Lots of time if you have in-depth conversations about this stuff with doctors they'll agree that watchful waiting is fine.  There bias is just to do everything all at once, and you sometimes have to tease out whether the test is urgent, or something that can wait a while to see how things evolve, especially when there's a reasonable explanation for what's going on (normal child daydreaming).  [/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics