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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Seizure Disorder And Encephalomalacia

Hello, My wife had a craneotomy to repair a ruptured AVM back in 1984. As a result, she has encephalomalacia based on recent MRIs of her brain. Over the last 10 years, she has also developed a seizure disorder which we are having a hard time treating. We ve been to a neurologist and have had scalp EEGs done which come up negative. Because of the negative EEGs, the neurologist claims she is having psuedo-seizures which I totally disagree with. At this point, we are at a loss as to where to go from here. We have had other neurologists tell us the same thing. She s on 400mg of Zonogran and 300mg of Vimpat which is no longer helping her. We need to see a specialist that will treat her based on the assumption that what is going on is a real seizure that is deep in the brain. So...my questions are 1) can seizures occur deep in the brain that won t register on a scalp EEG? and 2) what sort of specialist can help us? Neuropsychologist/Neuropsychiatrist perhaps?
Mon, 20 Jul 2015
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
Seizure disorder can occur due to various causes and it can have its focus of origin on different parts of brain.
They can arise from the surface or from deeper parts of brain.
Management of seizures is with anti-epileptics.
Encephalomalacia refers to softening or degeneration of brain and it is not surrounded by gliosis which is normal phenomenon after injury to brain parenchyma.
Once changes appear in encephalomalacia, there is no way to reverse it.
Thus, any ongoing disease process in brain should be avoided.
For management of seizures, you need to consult a neurologist.

Thanks and take care
Dr Shailja Puri
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Suggest Treatment For Seizure Disorder And Encephalomalacia

Hello and welcome to HCM, Seizure disorder can occur due to various causes and it can have its focus of origin on different parts of brain. They can arise from the surface or from deeper parts of brain. Management of seizures is with anti-epileptics. Encephalomalacia refers to softening or degeneration of brain and it is not surrounded by gliosis which is normal phenomenon after injury to brain parenchyma. Once changes appear in encephalomalacia, there is no way to reverse it. Thus, any ongoing disease process in brain should be avoided. For management of seizures, you need to consult a neurologist. Thanks and take care Dr Shailja Puri