[Long-term ambulatory EEG in pediatrics. Possibilities and limitations]
Insights
Long-term electroencephalogram (EEG) recordings are valuable for diagnosing seizure disorders in children when routine EEGs are inconclusive. This method aided in diagnosis and treatment adjustments for many children, improving seizure control.
Area of Science:
- Neurology
- Pediatrics
- Clinical Neurophysiology
Context:
- Routine electroencephalograms (EEGs) are often insufficient for diagnosing seizure disorders in children.
- Pediatric patients with suspected epilepsy require accurate diagnostic tools.
Purpose:
- To evaluate the diagnostic utility of long-term EEG recordings in children with suspected seizure disorders.
- To identify specific EEG patterns associated with attention deficit and enuresis.
Summary:
- Fifty-four long-term EEG recordings in 36 children led to diagnostic and therapeutic changes in 12, with 7 experiencing reduced epileptiform attacks.
- Short bursts of 3/sec spike and wave discharges were observed in children with attention deficit and enuresis, resolving with anticonvulsant treatment.
- Recommendations for long-term EEG use include frequent episodic disturbances, non-diagnostic routine EEGs, and abnormal initial findings.
Impact:
- Long-term EEG recordings can improve diagnostic accuracy and treatment efficacy for pediatric seizure disorders.
- Identifies potential EEG correlates for attention deficit and enuresis, suggesting a link to neurological dysfunction.
- Supports the increased utilization of long-term EEG in specific pediatric populations with episodic disturbances.
Abstract:
36 children aged 7 +/- 4 years with suspected seizure disorders had insufficient routine EEGs. After 54 long term EEG registrations the diagnosis and therapy had to be changed in 12 children, in 7 of them the frequency of epileptiform attacks therefore decreased. In 3 children with marked attention deficit in history during daytime and nighttime bedwetting the long term EEG showed mainly very short 3/sec spike and wave discharges (duration 0.5-2 sec). It is discussed that these bursts are EEG equivalents of attention deficit and bedwetting respectively, which disappeared by anticonvulsive treatment. Because the application of this method is very tedious we recommend the use of long term EEG recordings in children only under the following circumstances: 1. suspected attacks of seizures or episodic disturbances of behaviour and/or attention and/or enuresis at least twice a week; 2. lack of three conclusive routine EEG recordings despite of provocation procedures with full cooperation of the patient; 3. follow-up when initially abnormal. Our results are in favour of the more frequent use of a long term EEG in children having the above mentioned episodic disturbances.
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