Frequency of epileptiform discharges in the sleep-deprived electroencephalogram in children evaluated for...

Area of Science:

• Neurology
• Pediatrics
• Clinical Neurophysiology

Background:

• Attention-deficit disorders (ADD) are common in children and adolescents.
• Electroencephalogram (EEG) is a tool used in neurological evaluations.
• Epileptiform discharges can sometimes be present in individuals without a clinical diagnosis of epilepsy.

Purpose of the Study:

• To determine the frequency of epileptiform discharges in the EEG of children and adolescents evaluated for attention-deficit disorders.
• To characterize the types and locations of epileptiform discharges found.
• To assess the role of sleep and sleep deprivation in EEG findings.

Main Methods:

• Retrospective analysis of 624 EEG records from children and adolescents referred for attention-deficit disorder evaluation.
• Classification of EEG findings as normal or abnormal, with further categorization of abnormalities (focal, generalized, or both).
• Analysis of the influence of sleep and sleep deprivation on the detection of epileptiform discharges.

Main Results:

• 26.1% of the EEGs reviewed showed abnormalities.
• Among abnormal EEGs, focal epileptiform discharges were observed in 42.9% and generalized discharges in 41.7%.
• Sleep-deprived EEGs were essential for detecting abnormalities in 94.5% of abnormal records.

Conclusions:

• Approximately one-quarter of children evaluated for attention-deficit disorders without a prior epilepsy diagnosis show epileptiform discharges on EEG.
• Focal epileptiform discharges are common, often localized to central, frontal, and temporal regions.
• Sleep-deprived EEG is crucial for identifying epileptiform abnormalities in this population, suggesting further study on EEG utility in ADD management is warranted.