Related Experiment Videos
Neuroradiological manifestations of focal polymorphic delta activity in children
J Maytal1, G P Novak, S B Knobler
1Division of Pediatric Neurology, Schneider Children's Hospital, Bronx, NY.
Insights
Focal continuous polymorphic delta activity (PDA) in children often lacks neuroradiological abnormalities, unlike in adults. This finding highlights the importance of considering EEG findings even without clear imaging evidence in pediatric cases.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Neuroradiology
Background:
- Focal continuous polymorphic delta activity (PDA) is an electroencephalogram (EEG) finding in children.
- Understanding its correlation with neuroimaging is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the neuroradiological and clinical correlations of focal continuous PDA in pediatric patients.
- To compare the prevalence of focal continuous PDA with and without neuroimaging abnormalities in children versus adults.
Main Methods:
- Retrospective review of 125 EEG records from 87 pediatric patients with continuous focal or lateralized PDA.
- Analysis of neuroimaging (CT or MRI) performed within 8 weeks of EEG in 80 patients.
- Correlation of EEG findings with imaging results and clinical presentation (seizures).
Main Results:
- 48% of pediatric patients with focal continuous PDA showed no correlated neuroimaging abnormalities.
- Focal abnormalities correlating with EEG were found in 52% of patients.
- Generalized EEG abnormalities were more common with generalized neuroimaging abnormalities.
Conclusions:
- Focal continuous PDA in children frequently occurs without concurrent neuroradiological abnormalities.
- This incidence is significantly higher than reported in adult populations.
- Clinical context, particularly seizures, is important when interpreting focal continuous PDA in children.
Abstract:
To examine the neuroradiological and clinical correlations of focal continuous polymorphic delta activity (PDA) in children, we reviewed the records of patients with continuous PDA that was either focal or lateralized to one hemisphere. Of 2571 electroencephalograms (EEGs) performed between July 1, 1988, and December 31, 1990, a total of 125 records from 87 patients revealed continuous PDA. Eighty of these patients had neuroimaging performed either by computed tomographic scan (n = 59) or by magnetic resonance imaging (n = 38) within 8 weeks of the EEG. Twenty-two patients (28%) showed no abnormalities on neuroimaging, 16 patients (20%) showed diffuse abnormalities, and 42 patients (52%) showed focal abnormalities that correlated with the EEG findings. Most (18 of 22) patients with no neuroradiological abnormalities presented to the hospital with seizures from various causes. The presence of focal spikes or additional focal EEG abnormalities did not differ significantly among the three imaging groups. Generalized EEG abnormalities and multifocal spikes were significantly more common among the patients who had generalized abnormalities on neuroimaging. Focal continuous PDA without correlated changes on neuroimaging occurred in 48% of patients, which is much higher than what has been reported in adults.