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Long-term EEG monitoring in uremic children on chronic dialysis treatment
1Section of Neurophysiology, Bambino Gesù Children's Hospital, Rome, Italy.
Insights
Abnormal electroencephalogram (EEG) activity is common in children on chronic dialysis. Long-term EEG monitoring revealed that these abnormalities often persist between dialysis sessions, suggesting an underlying neurological disorder rather than dialysis dependence.
Area of Science:
- Pediatric Nephrology
- Clinical Neurophysiology
- Neurology
Background:
- Patients on chronic dialysis frequently exhibit abnormal electroencephalogram (EEG) activity.
- This activity is often attributed to dialysis-related factors like dysequilibrium syndrome.
- The occurrence of these EEG abnormalities exclusively during dialysis sessions remained unclear.
Purpose of the Study:
- To investigate the temporal relationship of EEG abnormalities in children with end-stage renal failure undergoing chronic dialysis.
- To determine if abnormal EEG activity is confined to dialysis sessions or also present between sessions.
- To differentiate dialysis-dependent EEG events from those related to other neurological conditions.
Main Methods:
- Continuous 52-hour electroencephalogram (EEG) monitoring was performed on 10 children with end-stage renal failure.
- Monitoring encompassed both dialysis sessions and the interdialytic period.
- Clinical symptoms and blood pressure were recorded concurrently.
Main Results:
- Abnormal EEG tracings were observed in 5 out of 10 children.
- Two children showed paroxysmal slow waves associated with hypotension and syncope towards the end of dialysis.
- Three children exhibited EEG abnormalities that were also present during the interdialytic period and were not clinically apparent.
Conclusions:
- Long-term EEG monitoring is crucial for distinguishing dialysis-related electrical events from non-dialysis-related events.
- EEG abnormalities in children on chronic dialysis are not always dialysis-dependent.
- These findings suggest that abnormal EEG activity may frequently indicate a pre-existing or underlying neurological disorder in this population.
Abstract:
Even in the absence of clinically apparent seizures, patients undergoing chronic dialysis often exhibit abnormal EEG activity, which is usually attributed to the type of dialysis or to the dysequilibrium syndrome. To find out whether these abnormalities occurred only during dialysis sessions, 10 children with end-stage renal failure undergoing chronic dialysis were continuously monitored for 52 h during dialysis and between two sessions. The EEG tracing was abnormal in 5 children. Two had paroxysmal aspecific slow waves towards the end of the sessions, with a fall in blood pressure, malaise and fainting. In 3 children EEG abnormalities - also present in the interdialytic period - were not clinically apparent. Long-term EEG monitoring in these cases distinguished between the electrical events that were related to dialysis and those that were not. It also suggested that, rather than being dialysis-dependent, these events frequently reflect a basic neurological disorder.