Electroencephalography in childhood conduct and behavior disorders

Area of Science:

• Child Neurology
• Behavioral Pediatrics
• Clinical Neurophysiology

Background:

• The pathophysiology of childhood behavior disorders remains debated.
• The utility of electroencephalography (EEG) in evaluating these conditions is unclear.
• Specifically, the link between episodic disturbances, epilepsy, and chronic problems with subclinical neurological issues is controversial.

Purpose of the Study:

• To evaluate the effectiveness of routine electroencephalogram (EEG) screening in children admitted for behavioral problems.
• To determine if EEG findings correlate with specific behavioral diagnoses or underlying neurological disorders.

Main Methods:

• Conducted routine EEG screenings on 86 children hospitalized for conduct disorder, attention deficit hyperactivity disorder, or both over 18 months.
• Analyzed EEG results for abnormalities such as background slowing or paroxysmal discharges.
• Correlated EEG findings with clinical presentation, neurological status, and presence of epilepsy.

Main Results:

• 91% of EEGs were normal or showed normal variants.
• Only 9% of EEGs revealed abnormalities (background slowing, paroxysmal discharges).
• None of the neurologically normal, non-retarded children with abnormal EEGs had epilepsy or other diagnosed cerebral disorders.

Conclusions:

• Routine EEG screening appears to have limited diagnostic value for childhood behavior problems when there is no clinical suspicion of neurological disorder.
• Abnormal EEG findings in this cohort did not correlate with epilepsy or other cerebral disorders in neurologically normal children.
• Further investigation may be needed to identify specific subgroups of behavioral disorders that could benefit from EEG evaluation.