Hi

I am new here. We will be seeing our pediatric nuerologist on the 4th of April. My 7 yr daughter has been having many strange movements (dystonic arm twisting, vocalizations, head jerks, facial grimices, arm and shoulder shrugs or jerks, jaw biting down, raising of one leg upward, and blinking of eyes with only whites showing) this has been going on daily for over 3 weeks. Some as many as 10-12 minute or more. We have seen other tics in the past but with much less frequency and less severity. She had an EEG in 2003 which later was found to be abnormal that showed seizures predominately in both frontal lobes with generalization. Unfortuanately, our neurologist passed away and we moved to another state and the report was never sent to our new doctor. Our new doctor thought she was having Tics which she may be having now, seizures, or both.

Here is the report:

Here is the report:

Scalp EEG with scalp elecrtodes of International 10/20 system - 4 1/2 at that time now 7 1/2

Background consisted of a fair well regulated alpha rhythm of 8-9 Hz, seen maximally over the posterior head regions and responded to eye opening and closing.

Sleep and drowsiness were obtained and associated with slowing of the background rhythm, vertix sharp waves and spindles.

There were several 3-5 second bursts of rhythmic high amplitude delta (up to 750 microvolts) seen during sleep. The discharges were predominately bifrontal 3-4 Hz. There were intermixed spike and slow waves and sharp and slow waves as well as sharply configured delta. The frequency was 3-4 Hz. Only one episode was associated with a clinical jerk. The onset was predominatly bifrontal. The frequency was 3-4 Hz. The burst was an admixture of sharply configured delta, amplitudes were 750 microvolts.

Step-wase, photic stimulation for 10 second periods produced no appreciable driving response at frequencies from 1-30 Hz.

Hyperventilation was not performed secondary to no cooperation.

There was some excess muscle and movement artifact which limited their interpretation. The study lasted 1.5 hours.

Impression: This EEG is abnormal because of bursts of epileptiform discharges, occurring during sleep, which were predominatly bifrontal. This finding is associated with irritatie and potentially epileptogenic activity.

A few questions first of all would this be Frontal lobe seizures with secondary generalized seizures or just primary generalized seizures?

Most the movements are accompanied with a vocalization usually the same sound and other times her speech is drawn out like "m ..o o ..m" kind of a stutter. What types of vocalizations might one encounter with these types of seizures and what types of movements would one likely to see. Many of the jerks only last a second or less. She also used to have whole body jerking in her sleep and would have vomiting at times in her sleep that would wake her up or choke on her saliva in her sleep. We haven't noticed this for a long time but that we aren't there with her when she is sleeping either. It does seem like the movements stop when she goes to sleep since we don't hear the vocalizations.

She also has Fetal Anticonvulsant Syndrome, Autism with OCD Traits, and abnormal knee jerk reflexes. She also has adverse affects to many medications.

Thanks

Diana at wind_decor@yahoo.com

Any information or personal experiences with frontal lobe seizures would be appreciated.

Wow, you're dealing with a lot. I know about neurologists dying - mine died in the town I'm moving back to, and I'm not sure what I'm going to do. It's hard to find a good one.

Bi-frontal seizures can definitely cause strange movements...right frontal lobe is predominantly involved with social skills, inhibitions, and behavior. Left frontal lobe is more involved with intellectual reasoning, and some speech, depending on how close to the temporal lobe and speech centers it's located. Either frontal lobe can cause limb movements, depending on how close to the movement centers- right effects left side of body, left effects right side of body....a lot of people with frontal seizures are categorized as psychiatric for years since the patterns seem so odd from a neurological standpoint- you're fortunate that she's been tested well, and there's validation- first step to getting good treatment.

Can you get her to a Seizure/Epilepsy Center, or University Medical Center? They either have THE specialists, or enough interaction with various places around the country that they can get information back and forth to each other, and come up with a decent plan. It may take a bunch of trials of meds to find the right one, and different doses....but knowing the location of the seizure focus is a huge step. She may have other types of seizures that just didn't show up on that particular EEG- some seizures are too deep in the brain to be picked up by scalp electrodes.