Monday, March 26, 2012

The Results

Friday after work I went by Vanderbilt and picked up the CD of images to bring to her appointment Monday. I brought the CD over to my mom's on Saturday to look at the images the report was also included on the CD. Mom and I read it over and honestly became quite concerned. The two main items of concern were the statements "substantially incomplete myelin" and "possible lesion or artifact on the t2". Of course I googled the crap out of it and began freaking out - yes I know Dr. Google is ALWAYS wrong but I just couldn't help myself.

A few items to note so that you can fully understand the above terms.

Myelin is the white matter of the brain and surrounds the exterior of the brain. The purpose of the myelin sheath is to allow impulses to transmit quickly and efficiently along the nerve cells. If myelin is damaged, the impulses slow down. This can cause diseases such as multiple sclerosis and most children with delayed myelination are severely delayed.

An image artifact is any feature which appears in an image which is not present in the original imaged object. An image artifact is sometime the result of improper operation of the imager, and other times a consequence of natural processes or properties of the human body. It is important to be familiar with the appearance of artifacts because artifacts can obscure, and be mistaken for, pathology. Therefore, image artifacts can result in false negatives and false positives.

I picked Todd up from the office and we went to Dr. Cruz's office. As always we went straight back (they are wonderful like that) I gave the nurse the CD of images. Dr. Cruz came in and stated that the MRI results were pretty insignificant which had me baffled. As we discussed he said that the statement "substantially incomplete myelin" was typical for her age because it shouldn't be complete at this age and that there is a huge difference between DELAYED myelination and INCOMPLETE myelination and that we will do another MRI at age 3 to see if it has fully developed as it should. Then we spoke about the lesion/artifact he said on the images that he looked at it was a very small dark spot deep in the brain - think the inner most part of the brain behind the right ear. This could be a cortical dysplasia or it could be nothing - it is still hard to tell since her brain still hasn't fully developed. We then discussed the original EEG and how it showed the spike at the front line of the brain. And then discussed the fact that we believe she had a seizure the other weekend I described how she hadn't napped all day and at dinner she became unresponsive for around 20 seconds. Then she slept horribly that night was extremely cranky and slept all day the next day. He said everything I described sounded spot on for a seizure but he was going to let it slide. The next seizure she has we will have to do labs to see how quickly she is metabolizing the medicine then up her medicine dosage and then do more labs. And we will also have to repeat the EEG this time doing it at Vanderbilt instead of Centennial. Over all it was a great visit and I walked away feeling much better. Out ultimate goal is for her to become completely seizure free and secondly to figure out why she is having the seizures.

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