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Electroencephalographic Patterns During Routine Polysomnography in Childhood and Association With Future Epilepsy

Robert C Stowe1, Daniel G Glaze2,3

  • 1Department of Medicine, Division of Sleep Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|April 7, 2019
PubMed

Insights

Abnormal electroencephalograph (EEG) findings during pediatric polysomnography (PSG) in children without a history of seizures are poor predictors of future epilepsy. Clinical context is crucial for interpreting PSG results and diagnosing seizures.

Area of Science:

  • Pediatric Neurology
  • Clinical Neurophysiology
  • Epileptology

Background:

  • Pediatric polysomnography (PSG) is essential for diagnosing sleep disorders and neurological conditions in children.
  • Electroencephalograph (EEG) abnormalities during PSG can sometimes indicate underlying neurological issues.
  • The predictive value of incidental EEG findings in pediatric PSG for future epilepsy diagnosis requires further investigation.

Purpose of the Study:

  • To determine the frequency of abnormal EEG records during pediatric PSG.
  • To assess the predictive value of these abnormal EEG findings for future seizure diagnosis and epilepsy.
  • To evaluate the utility of PSG-detected EEG abnormalities in a tertiary referral setting.

Main Methods:

  • Retrospective review of 1,969 pediatric PSG reports from 2013.
  • Collection of demographic, clinical history, indication, diagnosis, and EEG report data.
  • 30-month follow-up for seizure or epilepsy diagnosis.

Main Results:

  • Abnormal EEG results were found in 15.9% of pediatric PSG studies.
  • Incidental abnormal EEG findings, including interictal epileptiform discharges (IEDs), were noted in 9.4% of patients without prior seizure diagnosis.
  • Only 13 patients received a new epilepsy diagnosis within 30 months, primarily those with pre-existing neurodevelopmental disorders.

Conclusions:

  • Abnormal EEG findings on pediatric PSG without a history of seizures have limited prognostic value for epilepsy.
  • The utility of PSG-detected EEG abnormalities is questionable without supporting clinical context for seizures.
  • Clinical correlation is essential for interpreting EEG findings and diagnosing epilepsy in pediatric patients.
Abstract

Keywords:
electroencephalographyepilepsyinterictal epileptiform dischargeneurodevelopmental disorderspolysomnography

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