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EEG for children with complex febrile seizures
Pankaj B Shah1, Saji James, S Elayaraja
1Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri. Ramachandra University, Ramachandra Nagar, Porur, Chennai, Tamil Nadu, India, 600116.
Insights
No randomized controlled trials were found to support or refute the use of electroencephalographs (EEG) for children with complex febrile seizures. Further research is needed to establish EEG
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
- Evidence-Based Medicine
Background:
- Complex febrile seizures in children under five are characterized by prolonged duration, recurrence, or focal neurological signs.
- Electroencephalography (EEG) is often recommended by clinicians for evaluating complex febrile seizures, despite limited supporting evidence.
- The optimal timing and utility of EEG after complex febrile seizures remain areas of clinical uncertainty.
Purpose of the Study:
- To systematically assess the evidence regarding the use and timing of electroencephalography (EEG) in children under five years old who have experienced complex febrile seizures.
- To evaluate the diagnostic utility and clinical impact of EEG in this pediatric population.
Main Methods:
- A comprehensive literature search was conducted across multiple databases, including Cochrane Epilepsy Group Specialized Register, CENTRAL, MEDLINE, and ClinicalTrials.gov, up to January 2017.
- The review included only randomized controlled trials (RCTs) that investigated the utility and timing of EEG after complex febrile seizures in children.
- Study selection, data extraction, and quality assessment were performed independently by multiple reviewers, with disagreements resolved through consensus.
Main Results:
- Out of 41 potentially eligible studies identified, no randomized controlled trials (RCTs) met the inclusion criteria for this review.
- The current evidence base lacks high-quality RCTs to either support or refute the routine use of EEG following complex febrile seizures in young children.
- No new relevant studies were identified since the previous version of this review.
Conclusions:
- There is a significant lack of evidence from randomized controlled trials to guide the clinical use of EEG in children with complex febrile seizures.
- Future research, specifically well-designed RCTs with adequate sample sizes, is necessary to determine the true value and appropriate timing of EEG in this context.
- The current practice of recommending EEG for complex febrile seizures is not supported by robust scientific evidence from RCTs.
Background:
Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.
Objectives:
To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.
Search Methods:
For the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (23 January 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 23 January 2017), MEDLINE (Ovid, 23 January 2017), and ClinicalTrials.gov (23 January 2017). We applied no language restrictions.
Selection Criteria:
All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.
Data Collection And Analysis:
The review authors selected and retrieved the articles and independently assessed which articles should be included. Any disagreements were resolved by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by Cochrane.
Main Results:
Of 41 potentially eligible studies, no RCTs met the inclusion criteria.
Authors' Conclusions:
We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children. An RCT can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size. Since the last version of this review, we have found no new studies.
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