Assessment of EEG as a Diagnostic and Prognostic Indicator Tool in the Febrile Seizures
Latika Mohan1, Nitu Roy1, Yogesh Singh1
1Department of Physiology, AIIMS, Rishikesh - 249 201.
Insights
Electroencephalography (EEG) is a sensitive tool for diagnosing febrile seizures in children, showing high sensitivity and negative predictive value. While useful, EEG results should be considered alongside clinical support for comprehensive febrile seizure management.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Febrile seizures are common in childhood.
- Electroencephalography (EEG) is utilized to evaluate neurological activity.
- Assessing the diagnostic and prognostic utility of EEG in febrile seizures is crucial.
Purpose of the Study:
- To evaluate the diagnostic and prognostic accuracy of EEG in children with febrile seizures.
- To determine the sensitivity, specificity, and predictive values of EEG.
Main Methods:
- Prospective study of 50 children with febrile seizures.
- Two EEG recordings were performed: one within a week and another at 3 months post-seizure.
- Standard EEG protocols with activation procedures including sleep deprivation were employed.
Main Results:
- Abnormal EEG findings, particularly epileptiform discharges, were present in 54% of children.
- Sleep deprivation proved most effective in identifying abnormal EEG patterns.
- EEG demonstrated 90% sensitivity, 70% specificity, 72% positive predictive value, and 88% negative predictive value.
Conclusions:
- EEG is a sensitive diagnostic and prognostic tool for febrile seizures.
- It effectively identifies electrical abnormalities and electrographic features.
- EEG findings should be integrated with clinical data for optimal patient care.
Objective:
To assess the sensitivity, specificity, and predictive value of EEG as a diagnostic and prognostic tool in the febrile seizures.
Method:
This study was conducted on 50 consecutive children with febrile seizures attending the pediatric OPD of a tertiary care hospital. The children were prospectively identified and EEG was carried out on two occasions. First EEG was done within one week of febrile seizure episode and second EEG was done after 03 months of first EEG. EEG records were obtained with the standard international protocols for duration of 35 minutes which included 25 minutes of sleep record in all the children. Photic stimulation, hyperventilation and sleep deprivation were used as activation procedures. Descriptive analysis of EEG tracings was done in terms of background activity and presence of abnormal waveforms.
Result:
Paroxysmal EEG abnormalities were present in 54% of children. Most common epileptiform discharges were of generalized epileptic discharge followed by focal polyspikes. Sleep deprivation was the most effective activation procedure in evaluating febrile seizure with abnormal epileptiform discharge patterns. Validity measures of EEG in febrile seizure were found to have 90% sensitivity, 70% specificity, 72% positive predictive value and 88% negative predictive value within 95% confidence interval.
Conclusion:
EEG is a sensitive method for identifying and quantifying electrical activity in febrile seizures. EEG is useful as a diagnostic and prognostic tool in febrile seizures and can provide information regarding presence of abnormalities, degree of encephalopathy and electrographic features but like all diagnostic tool it is not fully infallible and requires further alternative diagnostic and clinical support.
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