Epilepsy Foundation

Mostly summarized from the textbook 'The Clinical Neurophysiology Primer', by Blume & Rutkove, 2006.

While slowing is considered an abnormality, it's important to remember that it's one of the most common EEG findings. It's not necessarily indicative of seizures, though it is often present in people with temporal lobe focal seizures.

Focal slowing suggests a problem, but doesn't really say what problem. It could be from a tumor, an infarct, or it could be because the person has just come out of a seizure or is having a migraine. (Yes, migraines cause focal slowing.) Even hypoglycemia or hyperglycemia (low or high blood sugar) can sometimes cause focal slowing.
The biggest thing that is relevant in intermittent slowing is the speed of the wave. The slower it is, the more serious a problem it indicates. If there are continuous bursts of slowing, (It's weird, but that's how they say it. Bursts of slowing merely mean it comes out of the blue, then goes away.) this can suggest eleptogenic focus. (oh, yes, there's the word - it can say the slowing is from epilepsy.)
If the frequency of slowing is rhythmic or shows "frequency evolution," epilepsy is also the most likely reason. Frequency evolution means the slow waves speed up and slow down over and over, but don't speed up to normal during that episode of slowing. Epilepsy is even more likely as the culprit when the focus of the slowing is in the temporal area. (Either of the temporal lobes can be sneaky little brats with this one, the fact that it's a temporal lobe acting up is a major indicator for E.)
So, you might ask, what does slowing look like on an EEG? (Okay, maybe you wouldn't, but I did, so here's a pic.) You can click on either picture to get a larger version.

And here's a normal one: (Can you tell the difference? heh. Good luck.)

Tags: eeg, eleptogenic, focus, slow, slowing, waves

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Replies to This Discussion

Cynthia:
Congrats on being sz free! hope things stay well in that area for you!
I have had sz since I was 9 (now 36). I have also had migraines most of my life, runs in family...although the sz do not. I've had lots of different kinds of migraines..course over the last # of years, all i seem to have are tension related and they're HORRID. I try to stay away from taking much as it seems not to help much...so basically all I can recommend might be: either moist heat or ice (which ever one will work-no more than 20 minutes @ a time)..massage...or just waiting til it goes away. If I can catch it just when its starting..SOMETIMES taking ibuprofen will help or in the past have tried Exedrin Migraine (although my neuro doesnt want me to take that often -dont know why really but oh well).
Have you or has your doc suggested seeing a chiropractor?? sometimes that can be helpful for many things.
And yes, my EEG is proof...migraine can be picked up on EEGs. Pretty much all the medical terminology in my report referred to migraine.
Much luck to you in helping your migraines!!
Jenn
Hi Jenn,

It's nice to meet you. I had a headache during the last eeg so maybe it did pick that up. however I have had a few times that I got that sick feeling in my stomache (aura) like I did before the surgery but it went away very quickly, and I haven't had one of those feelings in a very long time and hope they don't visit again.

I go back to my neurologist on April 8th so I'm sure he'll want to try another migraine med though I can't imagine how many more there are out there. I had crainoplasty surgery in Dec 08 so I think alot of the pain could be just from the healing of my skull. I had huge indentation left on the right side of my temple and above my ear, a plastic surgeon went in the same incision line and removed a plate and some screws from my skull and filled in the bur holes, so I look pretty good now :).

Thanks for your reply and best wishes to you.

Cindy
jjbeck said:
A lot of people get slowing and spiking in the same area,

Right, but Ava has the severe slowing on the left and the spiking on the rt.

The spiking in Ava's case makes a whole lot more sense ... she has all that damage to the rt hemi.
I understand the spiking on the rt... I just don't understand the slowing the left.
If the slowing was on the rt .. I'd get it, or if she had spiking on the left, I might get that too.
But to only have the severe slowing on the left is confusing to me.

One thought is this.
A few years ago we saw a wonderful ortho surgeon. He suggested Ava's leg issues looked more like a diplegia than a hemiplegia from stroke. So I have wondered if maybe Ava has some PVL.

I do not have the nickname of "scatter-brained" without a reason; it is not unusual for me
to have EEG's being scattered. In what I would imply best as "not confined to one specific
location" - in other words, here, there, there, and here, and there, and there. I have seen
some of my EEG's where it would look like someone was playing "Hop-Scotch" in my brain.

The chances are as my Neuro (never was my Neurologist, he just performed a lot of my
EEG runs in those days as he was the "Master of Electroencephalograms") would show them
to me, I would have spikes here, slowing there, seizure here, and so on - sometimes nothing
would be in generalization; even if there was a "small seizure activity in a couple locations"
he would write it off as abnormal because it was not sufficient enough data altogether to be
fully conclusive even though he already knew I was "epileptic" and he had seen epileptogentic
activities in full force, in those, which he would record as epileptic seizures and specified it
accordingly because they were more compressed and more detailed and profound than those
what I just posted above that were scattered. Two big differences, one not being so reliable
while the other being more reliable - while both were seizure activities; yes - but one was
the betterment of the other for obvious reasons.

It enabled the Physicians to pinpoint the specific location, targeting area(s), especially where
it is generating from is where they are looking for. Being scattered about and small little
things showing up does not help much, even if you had tons of them a day, just one small
spot appearing briefly is not going to do much good; however - the targeting area of pinpointing
the brain activity of seizure focus or focus area(s) is actually those that are more profound
on the EEG that reflects the generative activities in manifestation more clearly.

They do not want the "Big Seizures" - but rather a more profound small seizures which I had
implied in the above paragraph. Altogether - this narrows down the entire baseline and into
treating the patient better; as well as into the possibilities of surgical options, Gamma Knife,
VNS, et cetera. Not just all medication(s) or Keto diet.

I hope this brief summary I have typed up above clarifies everything bluntly and to a point
specifically of what the Neuroscience field wants and are looking for.
Migraines certainly cause abnormalities on EEGs. They are sometimes hard to tell apart from SPs.
Neuros and EEG techs like to act like reading EEGs is an exact science, but it's far from it. Nothing we know about the brain is exact, really. At least, not about the individual brain. Everyone is different, and maybe the difference is small, but even a TINY difference can change a person drastically.

Some of my "abnormalities" look more like seizures than the one seizure we caught did. I think that's because I had problems holding still, and muscle movements show up on EEGs, especially facial muscles.
I only really hold still during SPs. heh.
It was good to hear all your replys. I'm still having migraines and they seem to be getting worse. this week I've had one everyday, it gets to me because I have to keep going no matter what. I can't quit living and doing things with my family because of these migraines. I do exercise and watch what I eat not making a big difference though. I see my neurologist tomorrow Aug 27th, so we will see if he wants to add another migraine med or just continue to pray that the migraines stop and I can live a normal life. I don't work because the migraines are so frequently it would be hard for me to keep a job. I was substitute teaching but after having to leave several times because of a migraine I have given that up also.

I don't know if the neurologist will want to do another eeg or not, or if there is any reason to do one just because of these migraines. Life is good no matter what , I know it could always be worse.

God Bless,

Cindy/Tn

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