Ictal EEG of benign convulsion with mild gastroenteritis with in infants and children
Xiaoqing Luo1, Xiaoli Yu1, Jun Jiang1
1Department of Clinical Neuroelectrophysiology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Infants and children with mild gastroenteritis (BCWG) often experience focal secondary generalized tonic-clonic seizures, primarily originating in the posterior brain regions. Some cases also present with subtle non-convulsive seizures, highlighting the need for careful electroencephalogram (EEG) monitoring.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
- Gastroenterology
Background:
- Limited reports exist on electroencephalogram (EEG) findings during seizures in infants and children with mild gastroenteritis (BCWG).
- Understanding ictal EEG patterns is crucial for diagnosing and managing neurological complications in pediatric gastroenteritis.
Purpose of the Study:
- To retrospectively analyze the ictal EEG characteristics of convulsive episodes in children diagnosed with BCWG.
- To identify common seizure types and their origins in BCWG patients.
Main Methods:
- Retrospective analysis of seizure-phase EEGs from eight children diagnosed with BCWG between September 2016 and January 2022.
- Review of thirteen seizure-phase EEGs, focusing on ictal EEG patterns and seizure semiology.
Main Results:
- The majority of monitored epileptic seizures (9 out of 13) were focal with secondary generalization.
- Seizure onset was frequently observed in the right occipital region and other posterior cortical areas.
- Four non-convulsive seizures were identified, characterized by decreased movement/consciousness and evolving bilateral occipital delta slow-wave activity.
Conclusions:
- Focal secondary generalized tonic-clonic seizures are the predominant seizure type in BCWG, often originating in the posterior cephalic cortex.
- BCWG can be associated with previously unreported non-convulsive seizures with specific EEG patterns (bilateral occipital slow waves), which may be overlooked.
- These findings emphasize the importance of detailed EEG analysis in children with BCWG presenting with seizures.
Objective:
There are fewer reports on the ictal electroencephalogram(EEG) of convulsions in infants and children with mild gastroenteritis (BCWG). Our study retrospectively analyzed the ictal EEG characteristics of convulsive episodes of BCWG.
Methods:
The seizure-phase EEGs of children diagnosed with BCWG from September 2016 to January 2022 were searched and analyzed, and a total of thirteen seizure-phase EEGs of eight cases were analyzed retrospectively.
Results:
The age of onset of the disease in the eight children ranged from one year to two years and seven months. No epileptiform discharges were found during the interictal EEG. A total of thirteen epileptic seizures were monitored, of which nine were focal with secondary generalisation. Scalp EEG showed three onset of EEG seizures were in the right occipital region, two were in the right parietal and occipital regions, one was in the right parietal, occipital and posterior temporal region, one was in the right posterior temporal region, one was in the right occipital and posterior temporal region and one was in the right central and central midline region. In addition, four non-convulsive epileptic seizures, which manifested themselves as a decrease in movement and consciousness, with local δ slow-wave activity in bilateral occipital regions evolved to diffuse δ slow wave activity in epileptic seizures.
Conclusion:
Focal secondary generalised tonic clonic seizures were the main type of seizures in BCWG, and the seizure onset may been mostly in posterior cephalic cortex. It was previously unreported that some children of BCWG may combine with non-convulsive epileptic seizures with the onset of slow wave activity in the occipital region bilaterally and evolving into diffuse δ slow wave activity, which was not easily detected by parents and clinicians.
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