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Evaluation of EEG findings in pediatric patients presenting with dizziness
Ahmet Taşkın1, Yasemin Topçu1, Betül Kılıç1
1Department of Pediatric Neurology, Medipol University Faculty of Medicine, Istanbul, Türkiye.
Insights
In pediatric patients with dizziness, 11.6% showed epileptiform activity on EEG, a higher rate than general epilepsy prevalence. This highlights EEG
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Dizziness is a common symptom in children, with various potential causes.
- Epileptic seizures can sometimes manifest as dizziness, but this etiology is often underdiagnosed.
- Electroencephalography (EEG) is a key tool for diagnosing epilepsy.
Purpose of the Study:
- To determine the frequency of epileptic causes in pediatric dizziness.
- To correlate electroencephalogram (EEG) findings with clinical data in these patients.
- To assess the effectiveness of antiseizure treatment for dizziness.
Main Methods:
- Retrospective review of 736 pediatric patients presenting with dizziness.
- Analysis of clinical data, including physical examination, EEG results, and seizure history.
- Evaluation of response to antiseizure medication.
Main Results:
- 11.6% of patients exhibited epileptiform activity on EEG, significantly higher than the general epilepsy prevalence.
- Focal epileptiform discharges were more common than generalized ones.
- Complete resolution of dizziness was observed in 87.4% of patients treated with antiseizure medication.
Conclusions:
- Dizziness in children can be a presenting symptom of epilepsy.
- EEG is a valuable diagnostic tool for identifying epileptic activity in children with dizziness.
- Antiseizure treatment appears effective in resolving dizziness attributed to epilepsy.
Objective:
This study aimed to determine the frequency of epileptic etiology in pediatric patients presenting with dizziness, to correlate EEG findings with clinical data, and to evaluate the response to antiseizure treatment.
Methods:
The medical records of 736 pediatric patients who presented with dizziness to the Pediatric Neurology Outpatient Clinic of Medipol Mega University Hospital between September 2013 and January 2025 were retrospectively reviewed. Patients' sex, age, physical examination findings, EEG results, seizure history, and use of antiseizure medication were evaluated.
Results:
Of the patients, 61.7% (n = 454) were female and 38.3% (n = 282) were male. The median age was 11 ± 4.3 years (range: 2-18). Pathological findings were detected in 17 patients (2.3%) during physical examination. EEG was performed in 413 patients (56.1%). Among them, 87.7% had normal EEG findings, 11.6% showed epileptiform activity, and 0.7% had age-inappropriate background rhythm. Among the 48 patients with epileptiform discharges, 70.8% had focal and 29.2% had generalized activity. In terms of regional distribution, focal epileptiform activity most commonly involved the centrotemporal (n = 5), temporal (n = 5), occipital (n = 5), frontotemporal (n = 4), frontocentral (n = 4), and frontal (n = 4) regions. Less frequently observed foci included central (n = 3), centrotemporo-parietal (n = 2), centroparietal (n = 1), parietal (n = 1), and temporo-occipital (n = 1) areas. A clinical history of seizures was present in 20.8% of the patients with epileptiform activity. During follow-up, complete resolution of dizziness was observed in 87.4% of these patients.
Conclusion:
While the prevalence of epilepsy in the general population is approximately 1%, the rate of epileptiform activity among children presenting with dizziness was found to be 11.6% in this study. This suggests that dizziness may be a manifestation of underlying epileptic activity in certain cases. Therefore, EEG may provide significant diagnostic and therapeutic value in the evaluation of pediatric patients with dizziness.
