![]() ![]() Pregnancy management: Discussion of the risks and benefits of using a given ASM during pregnancy should ideally take place prior to conception. Surveillance: Reevaluation of EEGs at regular intervals to monitor disease progression, as well as assessment for changes in seizure semiology, changes in tone, and movement disorders monitoring of developmental progress and educational needs.Įvaluation of relatives at risk: A medical history from relatives at risk can identify those with ADSHE so that treatment can be initiated promptly. Adjunctive fenofibrate therapy or vagal nerve stimulation may be considered in individuals resistant to standard ASM. Resistance to ASM is present in about 30% of affected individuals and typically requires a trial of all appropriate ASM. KCNT1-related ADSHE is difficult to treat but may be treatable using quinidine based on limited data. Individuals with ADSHE associated with the CHRNA4 pathogenic variant p.Ser284Leu are more responsive to zonisamide than carbamazepine. Carbamazepine is associated with remission in about 70% of individuals, often in relatively low doses. Keep taking the seizure medicine that was prescribed.Treatment of manifestations: Many anti-seizure medications (ASM) may be effective. For example, if you've had meningitis, your risk of seizures is three times greater.īased on all of this information, your neurologist may diagnose seizures with confidence even though the result of your EEG was normal. The normal EEG does not mean that the neurologist was wrong in saying that you had a seizure. Your past medical history to see if it includes injuries or illnesses that would make you more likely to have seizures.The results of a physical examination and perhaps an MRI scan of your brain will be evaluated for relevant abnormalities.A description of the event from you and anyone who saw it is probably the most important information. Does it sound like a complex partial seizure or a fainting spell?.The neurologist also considers several other types of information. Making a diagnosis of seizures does not depend only on the results of the EEG. Specific techniques, like flashing lights or 2 to 5 minutes of deep breathing (hyperventilation), often are used to provoke abnormal brain waves so they can be recorded. Recording the "epilepsy waves" is helpful because it confirms the diagnosis and may identify the type of seizure disorder, but it is not necessary for diagnosis and treatment.The neurologist looks for spikes or sharp waves ("epilepsy waves") to confirm the diagnosis, but the absence of these abnormal brain waves does not mean you didn't have a seizure in the past. These waves may or may not show evidence of seizure activity. The EEG generally records brain waves between seizures, called interictal brain waves. The likelihood of recording a seizure during a routine EEG is small.When an EEG is done several hours or even days later, it misses the changes in electrical activity that occurred during the actual seizure. Once the seizure is over, the brain rapidly returns to normal in most individuals. During a seizure, the electrical activity is abnormal. ![]() If you aren't having a seizure at that time, there may not be any unusual brain waves for the test to record. This is because the EEG only shows brain activity during the time of the test. Even someone who has seizures every week can have a normal EEG test. Approximately one-half of all EEGs done for patients with seizures are interpreted as normal. A normal EEG does not mean that you did not have a seizure.Does a normal EEG mean that you didn’t have a seizure and the headache and muscle aches you felt were related to some other illness? The neurologist has just informed you that your EEG is normal even though you recently experienced your first tonic-clonic seizure. ![]()
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