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Paroxysmal spike and wave activity in drowsiness in young children: its relationship to febrile convulsions
Insights
Hypnagogic paroxysmal spike wave activity (PSW) in children
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Clinical Neurophysiology
Background:
- Paroxysmal rhythmic theta waves are common in normal pediatric sleep EEGs.
- A distinct pattern, hypnagogic paroxysmal spike wave activity (PSW), has been observed.
- The clinical significance of hypnagogic PSW, particularly its association with febrile convulsions (FC), is not well understood.
Purpose of the Study:
- To investigate the relationship between hypnagogic PSW, febrile convulsions (FC), and age in children.
- To determine if hypnagogic PSW is a predictor or correlate of FC.
- To differentiate hypnagogic PSW from normal sleep EEG patterns.
Main Methods:
- Three cohorts of children were studied: normal controls (G-1, n=94), pathological controls (G-2, n=126), and children with their first febrile convulsion (FC group, G-3, n=375).
- All children underwent EEG recordings without drug induction, capturing awake-drowsy-sleep-arousal states.
- Medical records of 169 children in the FC group were reviewed, specifically noting the presence or absence of hypnagogic PSW.
Main Results:
- The study identified hypnagogic PSW in a subset of children.
- Analysis focused on the prevalence and characteristics of hypnagogic PSW in relation to FC and age.
- (Further results pending full abstract review)
Conclusions:
- Hypnagogic PSW may represent a distinct EEG pattern in children.
- Further research is needed to clarify the association between hypnagogic PSW and febrile convulsions.
- Understanding this EEG pattern could aid in pediatric neurological assessments.
Abstract:
Paroxysmal rhythmic theta waves appearing during early stages of sleep have long been recognized in the EEGs of normal children. A similar pattern with intermixed spikes appears to have a different correlation. We called this pattern 'hypnagogic paroxysmal spike wave activity' or 'hypnagogic PSW.' This investigation was designed to test whether there exists a relationship between hypnagogic PSW, febrile convulsions (FC) and age. We selected 3 cohorts of children: G-1 or normal control consisted of 94 children selected with the following criteria: complete normal neurodevelopmental examination and no personal or family history of FC, epilepsy, or other neurological disorder. They all had one EEG obtained without drug induction showing a clear sequence of awake-drowsy-sleep-arousal-awake states. G-2 or pathological control group consisted of 126 children selected at random, referred to the Division of Neurophysiology at the Children's Hospital Medical Center for any problem excluding FC. At least one EEG met the criteria mentioned above. G-3 or FC group consisted of 375 children in whom the very first seizure was associated with fever without evidence of other causes for the convulsion. All met the same EEG criteria of G-1 and G-2. The medical record of 169 children of this group (40 with hypnagogic PSW and 129 without hypnagogic PSW) were reviewed.(ABSTRACT TRUNCATED AT 250 WORDS)