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[Seizures recorded upon awakening in the child: diagnostic difficulties]
Insights
Seizures during awakening, or "awakening seizures," are common in children with epilepsy, particularly West syndrome. Distinguishing these seizures from normal arousal on EEG requires further study due to poorly understood patterns.
Area of Science:
- Neurology
- Pediatric Neurology
- Clinical Neurophysiology
Context:
- Spontaneous awakening events in children can present complex electroencephalogram (EEG) patterns.
- Differentiating pathological arousal from true epileptic seizures during awakening is challenging in pediatric populations.
- The incidence of seizures coinciding with awakening in various epileptic syndromes may be underestimated.
Purpose:
- To describe the electroencephalogram (EEG) patterns associated with spontaneous awakening in infants and children.
- To investigate the clinical manifestations of
- awakening seizures
- in a pediatric cohort.
- To assess the frequency and diagnostic challenges of seizures occurring during awakening in childhood epilepsy.
Summary:
- Electroencephalogram (EEG) analysis and clinical observation of 34 infants and children revealed confirmed
- awakening seizures
- in 27 cases (18 with epilepsy, 9 with West syndrome).
- In 7 children, EEG findings were inconclusive for critical pathological awakening patterns.
- The study suggests that seizures during awakening, observed in 18% of recorded seizures over two years, might be underdiagnosed due to poorly understood EEG characteristics.
Impact:
- Highlights the potential underestimation of seizures associated with awakening in pediatric epilepsy syndromes.
- Emphasizes the need for further research into EEG patterns during awakening to improve diagnostic accuracy.
- Informs clinical practice regarding the evaluation of spontaneous arousal events in epileptic children.
Abstract:
We describe the EEG patterns and the clinical modifications of spontaneous awakening in 34 infants and children. An "awakening seizure" could be confirmed in 27 children, including 18 with various epilepsies and 9 infants with West syndrome. In other 7 children, the analysis of the tracing could not conclude whether or not the pathological awakening patterns were critical. The frequency of seizures occurring with awakening in various epileptic syndromes might be underestimated: it rated 18% in our series of 150 children with a recorded seizure in a two years period. Since the EEG patterns occurring with awakening have been poorly studied in epileptic children, it may be difficult to distinguish a pathological arousal from an "awakening seizure".