Patient: My son is 9 years old, two years ago found inattentive, poor academic performance doctor recommended EEG, my son EEG shows. Basic rhythm – medium amplitude 10-10.5 C/S a wave, tonal amplitude generally roughly symmetrical on both sides, visual response present. Low-moderate amplitude 5-7 c/s o waves are seen in the anterior hemisphere in scattered or short segment distribution. A moderate amount of single or paroxysmal small spike-slow waves and spike-slow waves were seen in the left central region in the tracing, and epileptiform activity phase inversions were seen in the bipolar leads. An intelligence test was also done, 2 years ago. The results of the test were: 28 correct questions (60 questions), 79% IQ rating, 120 IQ perceptual discrimination (12 questions), 10 correct questions, 6 correct questions, comparative reasoning (12 questions), 5 correct questions, 6 correct questions, abstract reasoning (12 questions), 1 correct question. My son has never had a seizure. Six months ago, he took antiepileptic drugs, Levetiracetam tablets and half a capsule of Toltea in the morning and half a capsule in the evening, to no avail. I would like to ask Dr. Zhu to help me to answer whether it is epilepsy or not. Is the medication correct? Pediatrics Zhu Highest: First you should clarify what is the target behavior you are treating for your son? If you want to solve the problem of inattention and unsatisfactory academic performance, then the drugs you are using, Toltea and Keplar, I think, do not help to solve these two problems; on the contrary, Toltea has a counter effect on the cognitive function of children. If you want to solve the epilepsy problem, in principle, if there are no seizures, you don’t necessarily use drugs. That is, if there are no seizures, it is better not to take them. Of course, your child cannot rule out the possibility of non-convulsive seizures, such as seizures with impairment in consciousness or cognition without movement of the limbs. This type of epilepsy is relatively rare, and it is important to emphasize that despite the absence of movement, there are still seizure features, and consciousness and cognition should return to normal in the interictal period. The intelligence test your child took should belong to the Raven’s Reasoning Test, a commonly used intelligence screening method that expresses only the non-verbal part of intelligence. Your child’s performance on this test is of moderate to high level, with poor abstract reasoning ability, indicating that your child will have obstacles in learning math application problems, geometry problems, language writing, etc., and should belong to the category of specific learning skills disorder. Patient: Hi Professor Zhu, we had 7 EEGs in 2 years, 2 were not abnormal. 5 were basically the same as above, all were epileptiform discharges [left temporal, central zone], Dr. Ningbo thought it was epilepsy, so we took medication. They said that the problem of inattention and poor academic performance can be solved only if the epilepsy is cured. What do you think we should do now? Pediatrics, Zhu Hai-peak: Epileptic discharges in the middle temporal region can be treated without antiepileptic drugs if there are no clinical seizures. The commonly used central stimulant Ritalin used to improve attention is also not suitable for your child. You may want to try Zestar, which may help to improve attention, but it cannot be said to be absolutely effective. The only other way I can see is to start with educational training to improve your child’s learning skills.