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The value of early postictal EEG in children with complex febrile seizures
J Maytal1, R Steele, L Eviatar
1Division of Pediatric Neurology, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
Insights
An early postictal electroencephalogram (EEG) in neurologically normal children with complex febrile seizures has a low yield of abnormalities. Routine EEGs are not recommended for this patient group.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Febrile seizures are common in children.
- Complex febrile seizures may warrant further investigation.
- The utility of early postictal EEG in this specific population is debated.
Purpose of the Study:
- To evaluate the diagnostic value of early postictal electroencephalography (EEG) in neurologically normal children experiencing complex febrile seizures.
- To determine if routine EEG is beneficial for identifying abnormalities after complex febrile seizures in otherwise healthy children.
Main Methods:
- Retrospective chart review of neurologically normal children hospitalized for complex febrile seizures.
- Analysis of electroencephalogram (EEG) results obtained within one week post-seizure.
- Inclusion criteria focused on children with at least one complex feature (prolonged, repetitive, or focal) or multiple complex features.
Main Results:
- Thirty-three neurologically normal children with complex febrile seizures were included.
- All 33 patients exhibited normal postictal sleep EEGs.
- The study estimates with 95% probability that the abnormality rate in early postictal EEGs for this group is 8.6% or less.
Conclusions:
- The diagnostic yield of early postictal EEG in neurologically normal children with complex febrile seizures is low.
- The rate of EEG abnormalities is comparable to that observed in simple febrile seizures.
- Routine early postictal EEG is not clinically justified for neurologically normal children with complex febrile seizures.
Purpose:
To assess the usefulness of an early postictal EEG in neurologically normal children with complex febrile seizures.
Methods:
We conducted a retrospective chart review of all neurologically normal children who were hospitalized over a period of 2.5 years after complex febrile seizures, and had an EEG up to 1 week after the seizure.
Results:
Thirty-three patients (mean age, 17.8 months) qualified for inclusion into the study. Twenty-four patients were qualified as complex cases based on one factor (prolonged in 9, repetitive in 13, and focal in 2). Nine other patients had two complex factors: in six patients, the seizures were long and repetitive; in two patients, the seizures were focal and repetitive; and in one patient, the seizures were long, focal, and repetitive. Thirteen (39%) patients experienced prior febrile seizures. All 33 patients had a normal postictal sleep EEG. Our results indicate with a 95% probability that the true rate of abnormalities in an early postictal EEG performed on otherwise normal children with complex febrile seizures is 8.6% or less.
Conclusions:
The yield of abnormalities of an early postictal EEG in this population is low and similar to the reported rate of abnormalities in children with simple febrile seizures. The routine practice of obtaining an early EEG in neurologically normal children with complex febrile seizures is not justified.