Clinical value of subclinical seizures in children with focal epilepsy

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Updated: Jun 3, 2026

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
10:22

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Published on: December 6, 2016

Abel Velkey1, Zsuzsanna Siegler, József Janszky

  • 1Epilepsy Center, Bethesda Children's Hospital, Bethesda Street 3, Budapest, Hungary.

Epilepsy Research
|April 8, 2011
PubMed

Insights

Subclinical seizures (SCSs) are common in children with focal epilepsy, detected via scalp-EEG. These electrographic discharges often aid in diagnosing epilepsy, helping localize seizure origins and guide treatment decisions.

Area of Science:

  • Neurology
  • Pediatric Epilepsy
  • Clinical Neurophysiology

Background:

  • Subclinical seizures (SCSs) are electrographic discharges without clinical manifestations.
  • Understanding SCSs in pediatric focal epilepsy is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To determine the frequency, characteristics, and diagnostic utility of SCSs detected by scalp-EEG in children with focal epilepsy.
  • To assess the impact of SCSs on epilepsy evaluation and treatment.

Main Methods:

  • Analysis of a long-term monitoring (LTM) database of 322 pediatric patients (<18 years) with focal epilepsy.
  • Re-analysis of video-EEG data for all identified cases of SCSs.

Main Results:

  • SCSs were identified in 18% (59/322) of children, with 15% having no clinical seizures during LTM.
  • SCSs were associated with longer epilepsy duration and LTM duration.
  • SCSs provided supplementary diagnostic value in 85% of cases, aiding seizure onset zone localization (53%) and influencing treatment (12%).

Conclusions:

  • Scalp-EEG detected SCSs are a frequent and significant finding in pediatric focal epilepsy.
  • SCSs should be considered in the epilepsy evaluation process, alongside clinical symptoms and other EEG data.
  • This study represents the first assessment of SCSs recorded by scalp-EEG in this population.
Abstract

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