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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34678
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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It is ***** *****. I am looking on bursts of rhythmic focal

Customer Question

Customer: Hi - It is ***** *****. I am looking for information on bursts of rhythmic focal slowing in the right and left temporal lobes for my 16 yr old. He has history of absence seizures since age 8. Those have subsided, but EEG is difficult to interpret.
JA: Thanks. Can you give me any more details about your issue?
Customer: At his worse, he was having 100 absence seizures a day. After 1 1/2 years, we finally had sz control with Depakote. Took him off as per Dr after 1 1/2 years, but they returned. Soon after, new symptoms presented like partial seizures - confusion, tingling down one side of body, felt like all of his memory was wiped out and he is losing his mind. The only findings on the EEGs were 1. Bursts of intermittent temporal slowing lasting 1-10 seconds in the right/bitemporal/left temporal region during wakefulness and 2. Bursts of intermittent right and left rhythmic temporal slowing, 1-4 seconds, mostly right more that left. He tends to zone out but, he has issues with attention, anxiety, depression and some learning issues. There's so much - what else would be helpful to you?
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Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

What did his MRI show?

Customer: replied 1 year ago.
His last one was done w/o contrast about 2 yrs ago and was fine.
Expert:  Dr. Arun Phophalia replied 1 year ago.

Sorry for the delay. I had to rush to perform an emergency surgery, so I could not respond you earlier. I apologize for your wait.

The EEG abnormalities you mentioned can be due to following causes;

1) may not be pathological / may not be associated with a disease process. These are considered as psychomotor variant.

2) temporal lobe epilepsy. Abnormal slow activity is by far the most common EEG manifestation of focal brain dysfunction and is known to be associated with epilepsy.

3) rarely it can be associated with cerebrovascular disorder which in will warrant an MRA (magnetic resonance angiography) for ruling it out. Focal slowing is the most common abnormality associated with focal lesions of any type, like neoplastic, vascular, injury and infectious. It occasionally may be seen in mesiotemporal sclerosis or focal malformations of cortical development.

EEG is a test of cerebral function; hence, for the most part it is nonspecific as to ascertain the exact cause. He would need following investigations to ascertain the cause of his epilepsy and these wave form abnormalities'

1) Epilepsy protocol MRI.

2) MRI of the temporal lobe

3) MRI of malformations of cortical development.

4) SPECT scanning (Single-Photon Emission Computerized Tomography Scanning)

5) Functional MRI.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 1 year ago.

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Thank you.

Expert:  Dr. Arun Phophalia replied 1 year ago.

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