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What Does The Following EEG Report Indicate?

Posted on Mon, 27 Jul 2015

Question: Here is an EEG report done to evaluate epileptiform abnormalities. I was on zonisamide and duloxetine at the time. "The background during quiet wakefulness consists of a mixture of frequencies including symmetric, well-modulated and reactive 9 Hz rhythm. The dominant rhythm is intermixed with low voltage fast activity and scattered theta elements. With drowsiness there is dropout of the alpha rhythm and theta activity becomes more conspicuous over the middle regions. Throughout the study, there is intermittent left temportal polymorphic XXXXXXX slowing. No epileptiform abnormalities were seen.

Answered by Dr. Dr. Erion Spaho (52 minutes later)

Brief Answer:
EEG changes related to sleep states.

Detailed Answer:
Welcome back XXXXXXX

I have read your EEG results.

There is no seizures detected in that EEG.

Theta waves are a pattern of waves that corresponds to a drowsiness state of the person mixed with other wave types and become more prominent after the person falls asleep. ( REM phase of sleep).

Slowing of XXXXXXX waves is a feature of sleep too, so, in my opinion, there is nothing to worry about the EEG findings.

Hope this helps. I remain at your disposal for further questions and clarifications.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Erion Spaho (26 minutes later)

when I went to an otolaryngologist he did not hesitate to refer me back to neurology. It appeared to him that the problem is seizure related. In consequence I am about to have an in hospital workup either at Mayo Clinic or at U of XXXXXXX in XXXXXXX

Thank you.

Answered by Dr. Dr. Erion Spaho (6 minutes later)

Brief Answer:
You are welcome.

Detailed Answer:
Hi again XXXXXXX

There are no seizures diagnosed on the EEG you uploaded the results.

Hope to hear good things soon about your condition.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Erion Spaho (34 minutes later)

Hello! Glad to thank you again for our last go-around. I had a copy of what we said in the doctor's appointment. Very helpful.
The question now is Why does this EEG report say that this is an abnormal awake and drowsy EEG? If everything is fine, what is abnormal about it? And what is a "focal neuronal disfunction?" Those are the two questions!

Answered by Dr. Dr. Erion Spaho (7 hours later)

Brief Answer:
Focal neuronal dysfunction is nonspecific.

Detailed Answer:
Hello again XXXXXXX

EEG is a neurophysiologic test that assesses cerebral, or neuronal function, hence, in most cases is nonspecific as to etiology.

Focal brain, or neuronal dysfunction found in EEG, without structural abnormalities assessed by MRI, has been observed in transient ischemic attack, migraine, and even in abnormal perception of stimuli.

So, if there is no evidence on MRI about brain structural lesions and no evidence on EEG about seizures, then abnormalities found could be just part of the normal range, or associated with one of the conditions mentioned above.

Hope I've been understandable.

Best regards.

Above answer was peer-reviewed by : Dr. Prasad