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Corrigendum to "Absence seizure provocation during routine EEG: Does position of the child during hyperventilation affect diagnostic yield?" [Seizure 79 (2020) 86-89].

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Hyperventilation during routine electroencephalography: are three minutes really necessary?

Nathan Watemberg1, Michael Farkash1, Miki Har-Gil1

  • 1Meir Medical Center, Tel Aviv University, Israel.

Pediatric Neurology
|February 10, 2015
PubMed
Summary

For pediatric absence epilepsy, three minutes of hyperventilation during electroencephalography may not be necessary. Most children experience absence seizures within 90 seconds of hyperventilation onset.

Keywords:
EEGabsence seizureschildelectroencephalographyhyperventilationtime-to-event

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Area of Science:

  • Pediatric Neurology
  • Epilepsy Diagnostics

Background:

  • Hyperventilation is a standard provocative method in electroencephalography (EEG) for diagnosing absence seizures in children.
  • Current guidelines recommend three minutes of hyperventilation, but its necessity is questioned.

Purpose of the Study:

  • To determine the optimal duration of hyperventilation needed to provoke the first absence seizure in children with absence epilepsy.
  • To assess if the standard three-minute duration is clinically necessary.

Main Methods:

  • Retrospective review of 62 EEG studies in children with absence seizures provoked by hyperventilation.
  • Measurement of time from hyperventilation onset to the first and subsequent absence seizures.
  • Documentation of posthyperventilation seizures.

Main Results:

  • The mean time to the first absence seizure was 52 seconds (median 32 seconds).
  • 85.5% of children had an absence seizure within 90 seconds of hyperventilation onset.
  • Most children (68%) had only one seizure event during the procedure.

Conclusions:

  • The standard three-minute hyperventilation protocol in pediatric EEG may be unnecessarily long.
  • A shorter duration, potentially around 90-120 seconds, could be sufficient for diagnosing absence seizures.
  • Stopping hyperventilation once a seizure is observed could reduce patient discomfort.