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Video-EEG monitoring differences in children with frontal and temporal onset seizures
Yue Hu1, Li Jiang, Zhuqiong Yang
1Department of Neurology, Children's Hospital of Chongqing Medical University, No. 136 Zhongshan 2nd Road, Yu Zhong District, Chongqing, China, 400014.
Insights
Frontal and temporal onset seizures in children present distinct electroencephalogram (EEG) features. Frontal EEG onset seizures (FOS) show more frequent bilateral discharges than temporal EEG onset seizures (TOS).
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Seizures in children can originate from different brain regions, impacting clinical presentation and EEG findings.
- Differentiating between frontal and temporal onset seizures is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate and compare the clinical manifestations and electroencephalogram (EEG) characteristics of frontal EEG onset seizures (FOS) and temporal EEG onset seizures (TOS) in children.
- To identify specific EEG patterns associated with FOS and TOS.
Main Methods:
- Utilized 24-hour video-EEG monitoring in pediatric patients with seizure disorders.
- Analyzed clinical seizure semiology and interictal EEG features, including background activity, discharge location, and timing.
Main Results:
- Fewer children presented with TOS compared to FOS.
- Posterior temporal EEG onset seizures (PTOS) were more common than anterior temporal EEG onset seizures (ATOS) within the TOS group.
- FOS exhibited more frequent multi-focal and bilateral discharges, with rapid spread and secondary bilateral synchrony.
- TOS predominantly showed focal discharges and bursts of fast rhythms at onset, rarely displaying bilateral synchronous rhythms.
Conclusions:
- Clinical and EEG characteristics of TOS and FOS in children are distinct.
- EEG patterns, particularly discharge frequency, bilaterality, and spread, effectively differentiate between FOS and TOS.
Abstract:
The objective of this study was to explore the clinical manifestations and electroencephalogram (EEG) features in children with frontal and temporal onset seizures. The method used was video-EEG monitoring that was conducted for 24 h in children with seizure disorders. The results were as follows: There were fewer children with temporal EEG onset seizure (TOS) than with frontal EEG onset seizure (FOS) (p = 0.132). Within the TOS category, PTOS was most frequent, and ATOS was rare (p = 0.001). The mean duration of ATOS was longer than that of TOS and PTOS (p < 0.05). There were no significant differences in seizure frequency and nocturnal attacks between children with TOS and children with FOS. Furthermore, we observed the interictal EEG from three aspects: the background, the location of discharges, and the time of discharges. The frequency of the multi-focal and bilateral discharges of FOS was higher than that of TOS (p < 0.01). The FOS discharged easily and quickly spread to the bilateral hemisphere and formed secondary bilateral synchrony. Focal discharges predominated in TOS, and rarely showed the paroxysm of bilateral synchronous rhythm. Bursts of fast rhythms predominated in the onset of TOS. In contrast, there were a variety of ictal EEG in FOS. Finally, it was concluded that in the group of children studied, the clinical and EEG characteristics of TOS were different from those of FOS.
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