Video EEG outcome on children referred following a single unprovoked afebrile seizure (original) (raw)
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Seizure
Sleep disorders are common in epilepsy. Additionally, events of staring, jerking, or nocturnal behaviors are common presentations in neurology or sleep practice. Moreover, sleepiness and nocturnal awakenings are common symptoms in children with epilepsy and differentiation form ongoing seizures and sleep disorders is needed. However, limited data exist for the best evaluation methods. This study evaluated the usefulness of combined video electroencephalography (EEG) and polysomnography (PSG) studies (vEEG/PSG). Methods: Polysomnography custom database was searched for combined vEEG/PSG studies, performed from July 2010 to April 2014, which identified 240 studies. From chart review, data were collected for presenting symptoms, sleep disorder and epilepsy/neurology diagnoses, and EEG and PSG results. Results: Most common indications for performing combined vEEG/PSG were correlating sleep events with seizure occurrence, evaluating sleepiness, nocturnal awakenings and nocturnal events. Sleep physician evaluation and/or PSG were abnormal in 94% of the studies. The EEG was abnormal in 53% and events or seizures were recorded in 40% of the studies. Hence, vEEG/PSG addressed the diagnostic questions. Additionally, as compared to children with epilepsy, a significantly larger number of children with spells/parasomnia had a normal sleep evaluation including a normal PSG (9 Vs 37%, p = 0.00003). Conclusions: This study demonstrates that combined video EEG and polysomnography is useful in addressing the common management questions in children with epilepsy and suspicious nocturnal events. Additionally, sleep disorders are more common in children with epilepsy than parasomnia. Hence sleep evaluation is important in children with epilepsy. Further prospective studies are needed.
EEG Abnormalities in Children with a First Unprovoked Seizure
Epilepsia, 1994
We examined EEG findings from an ongoing study of 347 children with a first unprovoked seizure. EEGs were available in 321 (93%), and 135 (42%) had an abnormal EEG. EEG abnormalities included focal spikes (n = 77), generalized spike and wave discharges (n = 28), slowing (n = 43), and nonspecific abnormalities (n = 7). Abnormal EEGs were more common in children with remote symptomatic seizures (60%) than in those with idiopathic seizures (38%) (p < 0.003), more common in partial seizures (56%) than in generalized seizures (35%) (p < 0.001), and more common in children age >3 years (52%) than in younger children (12%) (p < 0.001).
2019
Bckground: Epilepsy is the most common neurological disorders that affect all age groups. It is characterized by at least two unprovoked seizures more than 24 hours apart. The most common investigation used for both diagnosis and management is an Electroencephalogram (EEG), which is relatively cheap and easy to perform. However, EEG requires technical expertise and is prone to misinterpretation. Objective: To determine the frequency of abnormal EEG findings in children with newly diagnosed epilepsy at tertiary care hospital. Method: It was a retrospective descriptive, cross-sectional study. Children with diagnosis of epilepsy admitted at Aga Khan University Hospital from January 2016 to December 2018, who underwent EEG were included in this study. Demographics, duration of seizure, type of seizure, day the EEG was performed, and EEG findings were collected on a structured proforma. Data analysis was done SSPS version 19. Results: During the study period of three years, 225 newly dia...
Asian Journal of Clinical Pediatrics and Neonatology, 2019
Background: To evaluate the role of EEG and Magnetic resonance imaging (MRI) in first episode of unprovoked afebrile seizure in a child. Subjects and Methods: Data was collected retrospectively from case records of patients admitted with seizures during the period between January 2016 to December 2018. All children with first episode of unprovoked afebrile seizure (1-15 years of age) were included in the study. Results: Case records of 108 patients with first episode of unprovoked afebrile seizures were reviewed. Out of these , 65 patients were investigated with MRI and EEG.54 children (83.1%)had generalized tonic clonic seizures(GTCS), 11 had partial seizures (16.9 %). EEG abnormalities were seen in 21 children, predominantly in GTCS type. The most common EEG abnormality observed was sharp and spike wave discharges .7 children (10.7 %) had abnormal (MRI). The accuracy of MRI detecting the abnormality when EEG was abnormal was 33.3 % (p < 0.05). Conclusion: This study illustrates that routine neuroimaging for all children with first episode of unprovoked afebrile seizures is gratuitous. Neuroimaging can be reserved for those patients with recurrence of seizures or those children with clinical findings suggestive of intracranial pathologies.
Electroencephalography Patterns in Children with First Unprovoked Seizure
2021
Background First unprovoked seizure (FUS) is a neurological health problem that occurs in an estimated 2% of children aged 16 years or younger. Electroencephalography (EEG) is an electrophysiological technique to record electrical activities arising from the brain; this technique can be used to evaluate patients with suspected seizures, epilepsy, and unusual concomitants. The objective of this study is to describe the EEG patterns in children with FUS and the factors associated with these EEG results. Method A retrospective analytic study was conducted in the Neuropaediatric Clinic, Dr Soetomo General Academic Hospital. The medical record data were obtained from January 2018 to December 2019. Children aged one month to 18 years with FUS and their complete EEG records were included. Descriptive statistics and the chi-square test with Cochran's Q test and Mantel–Haenszel tests were used for statistical calculations. Results One hundred participants enrolled the study. The majority...
Journal of Neurology & Neurophysiology, 2015
Introduction: Seizures are among the most common neurological disorders in the pediatric age group. Up to 10% of children might experience at least one paroxysmal episode suggestive of seizure activity in their life. It is thought that 5% of all medical attendances to emergency department are related to seizures. Whether the first nonfebrile seizure is the kick start of long term epilepsy is always a question that physicians and families encounter. Ordering Electroencephalogram (EEG) for children with first non-febrile seizure is a subject of continuous debate. Objectives: To collect demographic background data for children (1 month to 14 years) who presented with the first non-febrile seizure, To determine the prevalence and pattern of EEG abnormalities in Children (1 month to 14 years) with first non-febrile seizure, and To collect possible evidence sufficient to make a recommendation for the use versus abandoning use of routine EEG in children with first episode of non-febrile seizure. Methods: In a retrospective single-center observational study around (400) children were admitted with first nonfebrile seizure to the Pediatric Emergency Centers (PECs) and their seizure were defined using the international league against epilepsy (ILAE) between January 2012 to December 2013 were studied. EEG was requested for 76 patients. Their EEG were reviewed and interpreted by pediatric neurology consultants. Patients' demographic data and EEG records are then analysed. Results: Infants unexpectedly represented a small proportion of our cohort. Male gender predominance was noticed. No significant correlation could be found in EEG yield in regard to seizure type. Certain patterns of EEG abnormalities were observed. Conclusions: Epileptic seizure should be diagnosed clinically and EEG is just a helpful tool. Utility of EEG is debatable in childhood first non-febrile seizure. EEG is helpful but interpretation should be individualized. EEG alone is not very good predictors of seizure recurrence or overall prognosis. Larger scale studies with longer follow up are needed.
24-Hour video EEG in the evaluation of the first unprovoked seizure
Clinical Neurophysiology Practice, 2021
Objective: To assess the gain in detection of epileptiform abnormalities in 24-hour EEG recordings following the first seizure. Methods: We identified patients who underwent 24-hour video EEG (VEEG) with ''first seizure" as an indication. We noted the presence or absence of epileptiform discharges (EDs) in the VEEG study and the latency for the appearance of such discharges. We compared the rate of EDs during the initial 60 min with those occurring only later during the recording. Results: Data from 25 patients, aged 15 to 59, were included. Of the 11 patients with EDs, eight (73%) appeared only after 60 min of recording. This equates to a 32% absolute increase in the detection of EDs across all patients. The latency to first EDs varied from one to 1080 min with a median of 170 min. In four cases, actual subtle seizures were recorded. Conclusion: This study suggests an increase in the detection of EDs with the 24-hour studies compared to the traditional shorter recordings, in the context of a first seizure. Significance: A standard EEG can be performed close to the seizure, followed by a longer up to 24-hour recording if the initial shorter study is unrevealing.
Acta Neurologica Scandinavica, 2002
The primary diagnosis of epilepsy is clinical but electroencephalography (EEG) plays a major role in evaluating epilepsy, recognizing that a normal routine EEG does not exclude the diagnose of epilepsy. The main indication for performing an EEG is clinical suspicion of an epileptic disorder. EEGs can also be useful in the evaluation of encephalopaties (metabolic, infectious, degenerative) and focal brain lesions (cerebral infarction, haemorrhage, neoplasms). In paediatric practice, the EEG might help to determine the level of maturation of the brain. The EEG is not useful in following the therapeutic effect of antiepileptic drugs (AEDs) as interictal epileptiform activity is affected very little by AEDs. An exception is absence epilepsy where the quantification of spike-wave episodes is helpful in following the effect of treatment.
2010
Article abstract-Objective: The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient management based on analysis of evidence. For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence. Methods: Multiple searches revealed relevant literature and each article was reviewed, abstracted, and classified. Recommendations were based on a three-tiered scheme of classification of the evidence. Results: Routine EEG as part of the diagnostic evaluation was recommended; other studies such as laboratory evaluations and neuroimaging studies were recommended as based on specific clinical circumstances. Conclusions: Further studies are needed using large, well-characterized samples and standardized data collection instruments. Collection of data regarding appropriate timing of evaluations would be important.