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Related Experiment Videos

Partial seizures presenting as life-threatening apnea

B Singh1, A al Shahwan, S M al Deeb

  • 1Department of Paediatric Neurology, Riyadh Armed Forces Hospital, Saudi Arabia.

Epilepsia
|September 1, 1993
PubMed
Summary

Apneic episodes in infants can be misdiagnosed. Video EEG monitoring is recommended to differentiate apneic seizures from other causes, preventing harmful treatments.

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Area of Science:

  • Pediatric Neurology
  • Neonatology
  • Epileptology

Background:

  • Apneic episodes are common in newborns but rare after one month, with differential diagnoses including gastroesophageal reflux, cardiac arrhythmias, idiopathic central apnea, and seizures.
  • Accurate diagnosis of apnea is crucial as treatments vary significantly and can be detrimental; for instance, caffeine for presumed idiopathic central apnea has precipitated seizures in some cases.

Observation:

  • Two infant cases of partial seizures presenting as apnea were studied.
  • Interictal electroencephalogram (EEG) was normal in one patient and showed focal spikes in the other.
  • 16-channel video EEG monitoring revealed focal ictal discharges from temporal areas preceding apnea onset in both patients.

Findings:

  • Partial seizures can manifest as apneic episodes in infants.
  • Video EEG monitoring effectively identified focal ictal discharges preceding apnea, confirming seizures as the cause.

Implications:

  • Video EEG monitoring is essential for accurate diagnosis of apneic episodes in infants when seizures are suspected.
  • This diagnostic approach can prevent misdiagnosis and guide appropriate, potentially life-saving, therapeutic interventions.
  • Relying solely on interictal EEGs can be unreliable, underscoring the importance of comprehensive video EEG monitoring.

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