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Absence seizure with generalized rhythmic delta activity
1Department of Neurology, University of Virginia School of Medicine, Charlottesville 22908.
Insights
Hyperventilation in children can trigger absence seizures, indicated by specific EEG delta activity. Prompt treatment with ethosuximide or valproate effectively controlled these seizures and EEG abnormalities.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Absence seizures are a type of generalized epilepsy common in children.
- Hyperventilation is a known provocative agent for absence seizures, but its EEG correlates require further elucidation.
Purpose of the Study:
- To investigate the electroencephalogram (EEG) findings during hyperventilation-induced spells in children.
- To determine the association between generalized rhythmic delta activity and absence seizures.
Main Methods:
- Seven children (5-11 years old) with staring spells underwent EEG with hyperventilation.
- EEG data was analyzed for specific patterns, particularly generalized rhythmic delta activity.
- Patients were treated with ethosuximide or valproate, and treatment outcomes were monitored.
Main Results:
- Hyperventilation reproduced clinical spells in all seven children.
- EEG during these spells showed generalized, rhythmic, delta activity of abrupt onset, high amplitude, and prolonged duration.
- One spontaneous spell also exhibited similar EEG changes.
- Ethosuximide or valproate led to spell improvement or complete control and abolished EEG abnormalities.
Conclusions:
- Generalized rhythmic delta activity during hyperventilation in children is not always benign.
- This EEG pattern may be indicative of clinical absence seizures.
- Pharmacological treatment is effective in managing these seizure types and associated EEG findings.
Abstract:
In seven children, 5-11 years old, who presented with spells of staring or unresponsiveness, hyperventilation reproduced clinical spells that were accompanied on the EEG by generalized, rhythmic, delta activity. The discharges were usually of abrupt onset, extremely high amplitude, recurrent, and prolonged. One spontaneous staring spell, not provoked by hyperventilation, was also accompanied by generalized rhythmic delta activity. All patients had improvement or complete control of their spells and abolition of the EEG changes with ethosuximide or valproate. Delta activity during hyperventilation in children may not always be benign and may be associated with clinical absence seizures.