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I Had A Resting Eeg Done About 2 Months Ago
Question: I had a resting eeg done about 2 months ago that was videoed. I was not given a follow up appointment until about a week ago. I know my neurologist did not review the video before my visit because he asked me if I had the test results when I got there as if he did not think his clinic had them.
He then hurriedly printed the report (without watching the video) and told me it was abnormal due to some wave activity the technologist captured on the report and showed me a few screen shots. The report also stated that no seizures were detected and no abnormal rhythm was detected. It also stated that there were no abnormal rhythms detected during hyperventilation and during the photic stimulation. Yet due to a few sharp and XXXXXXX waves and inter ictal activity was what made it abnormal.
I also had a brain CTA done around that time that was called “normal” but a suspected frontal 8mm calcified meningioma was detected and mentioned in the written report and he never mentioned that to me. He did not offer to do bloodwork or acknowledge other causes for the abnormal waves that were found. He pushed medicine on me without other options or discussion. I have a sleep study this week that was ordered months ago because I am also having sleep issues too. I have a lot of other chronic health issues too and I am seeking a second opinion on the above results and possible further testing from a neurologist who specializes in epilepsy (this first doctor was a neurologist but did not claim epilepsy was a specialty). He also said I was not epileptic. I also want to mention I had herniated cervical discs and a compressed spinal cord when I first noticed these brief neck jerks I went to him about in the first place. Since the cervical disc surgery last month they have resolved. The eeg was done before my surgery. I also struggle with anxiety and PTSD but am not medicated at this time.
I want to know if I am justified in getting a second opinion next week from an epilepsy doctor rather than rush to a diagnosis that I feel like was arrived at in a hap hazard way? I feel like he just read the report to me as the technician wrote it and did not take all factors into account when interpreting it. Can EEGs be wrong or machines be calibrated incorrectly? It was not done in a hospital but off site in some office complex clinic type setup. Thank you!
He then hurriedly printed the report (without watching the video) and told me it was abnormal due to some wave activity the technologist captured on the report and showed me a few screen shots. The report also stated that no seizures were detected and no abnormal rhythm was detected. It also stated that there were no abnormal rhythms detected during hyperventilation and during the photic stimulation. Yet due to a few sharp and XXXXXXX waves and inter ictal activity was what made it abnormal.
I also had a brain CTA done around that time that was called “normal” but a suspected frontal 8mm calcified meningioma was detected and mentioned in the written report and he never mentioned that to me. He did not offer to do bloodwork or acknowledge other causes for the abnormal waves that were found. He pushed medicine on me without other options or discussion. I have a sleep study this week that was ordered months ago because I am also having sleep issues too. I have a lot of other chronic health issues too and I am seeking a second opinion on the above results and possible further testing from a neurologist who specializes in epilepsy (this first doctor was a neurologist but did not claim epilepsy was a specialty). He also said I was not epileptic. I also want to mention I had herniated cervical discs and a compressed spinal cord when I first noticed these brief neck jerks I went to him about in the first place. Since the cervical disc surgery last month they have resolved. The eeg was done before my surgery. I also struggle with anxiety and PTSD but am not medicated at this time.
I want to know if I am justified in getting a second opinion next week from an epilepsy doctor rather than rush to a diagnosis that I feel like was arrived at in a hap hazard way? I feel like he just read the report to me as the technician wrote it and did not take all factors into account when interpreting it. Can EEGs be wrong or machines be calibrated incorrectly? It was not done in a hospital but off site in some office complex clinic type setup. Thank you!
Brief Answer:
EEG 2nd opinion- All for it under the circumstance
Detailed Answer:
I've read through your concerns regarding the EEG read.
I believe any patient who is uncomfortable with the results of a medical testing procedure in terms of either HOW it was done or WHAT the results were as explained by their physician for reasons as you've explained is always justified in seeking another opinion. I was always trained never to stand in the way of a patient asking for a 2nd opinion. Some physicians actually do take offense to such a move. Others may not actively try to dissuade patients but may make them feel somehow as if they're "making unncessary."
My opinion is that if one does the best they can with interpreting something for a patient and the result is not satisfactory (whatever the reason) I will not likely be able to recruit that patient into believeing or trusting what I have to say UNLESS they actually do hear it from someone else.
To date, I can't think of a single case where a patient has a sought a 2nd opinion where it would've been BETTER for either myself or the patient not to have gotten it...because at the time....THAT IS WHAT THE PATIENT wished to do....so by all means...based upon what you've say I would support your interest in having another doctor get the study.
I also counsel patients to usually consult with SUBSPECIALISTS anyways if it does come to ANYTHING that I don't truly believe is in my wheelhouse of knowledge and experience. Not all neurologists feel that way because of course, the risk is one loses patients...but honestly, I'd much prefer having a smaller clientele whose problems I'm very comfortable with in terms of how to manage (including at least several alternatives in case first intention doesn't work) and know that the patients have confidence in me to take good care of them rather than try and purport levels of expertise simply upon being a neurologist and then, end up being faced with rare zebra types of cases that I've never seen in training or if so, only a couple which is then, a risk for me and the patient and will tend to erode the trust between us if something were to go wrong...but maintain a larger number of patients.....bad reviews on the internet go a long way these days from those types of scenarios!
So, yes, by all means....seek out a 2nd opinion from an epileptologist. And yes as well to the question on ERRORS by machine reading programs as opposed to a person. I do read my own EEG's on my patients but I do so without reading any of the machine jargon (which does contain errors and overcalls) and THEN, I will read the report generated by the specialty physician. I do not look sending patients to "cookie cutter" diagnostic centers to get reads UNLESS I know who is reading the studies. Furthermore, most of those places WILL NOT TELL ME WHO their readers are (they claim privacy issues...HA!). I send my patients for studies either to trusted and known colleagues who have the proper equipment in their clinics/offices...or I send them to the closest academic center. In XXXXXXX we have the luxury of 2 excellent academic centers (3 if you count the VA Hospital for patients who are Vets)....but I send patients for procedural tasks to them, not to corner store diagnostic cafes....big mistake if you just happen to get the wrong person on call that day!
EEG machines are not so much calibrated incorrectly just to be sure you understand....but reads can be wrong when read by machines....or people who are not well qualified....I would be very disappointed in any colleague who simply "agreed" with a technician's calls because I can't tell you how much of a chasm there is there between a technician's knowledge and an epileptologist's! But that's for a whole 'nuther editorial! LOL.....
If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in being kept in the loop with how things progress so please drop me a line and let me know how things go next week.
Cheers!
This query has utilized a total of 25 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
EEG 2nd opinion- All for it under the circumstance
Detailed Answer:
I've read through your concerns regarding the EEG read.
I believe any patient who is uncomfortable with the results of a medical testing procedure in terms of either HOW it was done or WHAT the results were as explained by their physician for reasons as you've explained is always justified in seeking another opinion. I was always trained never to stand in the way of a patient asking for a 2nd opinion. Some physicians actually do take offense to such a move. Others may not actively try to dissuade patients but may make them feel somehow as if they're "making unncessary."
My opinion is that if one does the best they can with interpreting something for a patient and the result is not satisfactory (whatever the reason) I will not likely be able to recruit that patient into believeing or trusting what I have to say UNLESS they actually do hear it from someone else.
To date, I can't think of a single case where a patient has a sought a 2nd opinion where it would've been BETTER for either myself or the patient not to have gotten it...because at the time....THAT IS WHAT THE PATIENT wished to do....so by all means...based upon what you've say I would support your interest in having another doctor get the study.
I also counsel patients to usually consult with SUBSPECIALISTS anyways if it does come to ANYTHING that I don't truly believe is in my wheelhouse of knowledge and experience. Not all neurologists feel that way because of course, the risk is one loses patients...but honestly, I'd much prefer having a smaller clientele whose problems I'm very comfortable with in terms of how to manage (including at least several alternatives in case first intention doesn't work) and know that the patients have confidence in me to take good care of them rather than try and purport levels of expertise simply upon being a neurologist and then, end up being faced with rare zebra types of cases that I've never seen in training or if so, only a couple which is then, a risk for me and the patient and will tend to erode the trust between us if something were to go wrong...but maintain a larger number of patients.....bad reviews on the internet go a long way these days from those types of scenarios!
So, yes, by all means....seek out a 2nd opinion from an epileptologist. And yes as well to the question on ERRORS by machine reading programs as opposed to a person. I do read my own EEG's on my patients but I do so without reading any of the machine jargon (which does contain errors and overcalls) and THEN, I will read the report generated by the specialty physician. I do not look sending patients to "cookie cutter" diagnostic centers to get reads UNLESS I know who is reading the studies. Furthermore, most of those places WILL NOT TELL ME WHO their readers are (they claim privacy issues...HA!). I send my patients for studies either to trusted and known colleagues who have the proper equipment in their clinics/offices...or I send them to the closest academic center. In XXXXXXX we have the luxury of 2 excellent academic centers (3 if you count the VA Hospital for patients who are Vets)....but I send patients for procedural tasks to them, not to corner store diagnostic cafes....big mistake if you just happen to get the wrong person on call that day!
EEG machines are not so much calibrated incorrectly just to be sure you understand....but reads can be wrong when read by machines....or people who are not well qualified....I would be very disappointed in any colleague who simply "agreed" with a technician's calls because I can't tell you how much of a chasm there is there between a technician's knowledge and an epileptologist's! But that's for a whole 'nuther editorial! LOL.....
If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in being kept in the loop with how things progress so please drop me a line and let me know how things go next week.
Cheers!
This query has utilized a total of 25 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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