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Objective To study the clinical value of video-electroencephalogram (VEEG) on the diagnosis and prognosis of neonatal seizure.Method From January 2016 to December 2017,the medical records of 118 neonates who had seizure and received VEEG in our hospital were collected.The results of VEEG and medical records were analyzed using x2 test,Fisher's exact test or rank sum test.Result Among the 118 neonates,94 cases(79.6％) had abnormal VEEG results,including 59 mildly abnormal cases,21 moderately abnormal cases,and 14 severely abnormal cases.The characteristics of mildly abnormal VEEG was delayed mature,and moderately and severely abnormal VEEG were paroxysmal abnormal activities.All of the severely abnormal VEEGs showed abnormal background activities.The incidence of abnormal background activities of severely abnormal group was higher than mildly and moderately abnormal group,the difference was significant (P＜0.001).Neonates with abnormal background activities had higher rates of epileptic seizure and delayed maturation than those with normal background,and the differences were significant (P＜0.001).Among 32 neonates with paroxysmal events,17 cases had non-epileptic events including subtle seizures,myoclonus seizures,and symmnetrical tonic seizures;15 cases had epileptic electrographic seizures and electro-clinical seizures,12 cases had focal seizures.The degree of abnormal VEEG had positive correlations with the incidences of epileptic seizures and delayed maturation (P＜0.001).Conclusion Neonates with seizure has higher rate of abnormal VEEG.Non-epileptic events presents as subtle seizures and myoclonus seizures,and epileptic seizures as focal seizures.The background activities of neonatal VEEG has important predictive value for prognosis.The worse the VEEG is,the higher the possibility of epileptic seizure and delayed maturation.
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Brain injury is one of the most common diseases in PICU.Bedside electroencephalogram monitoring is the most commonly used to evaluate cerebral function.Bedside electroencephalogram monitoring includes continuous electroencephalogram,video electroencephalogram and cerebral function trends,such as amplitude integrated electroencephalogram,envelope and band power.
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Narcolepsy is a common chronic sleep disorder attacking adolescence,characterized by a typical tetrad of excessive daytime sleepiness,cataplexy,sleep paralysis and hypnagonic/hypnopompic hallucinations,affecting both mental and psychological aspects of children.Thus,making an early diagnosis and therapy is of great importance.Clinical diagnosis mainly depends on the multiple sleep latency test across the video electroencephalogram.In this article,we mainly describe the diagnosis and treatment progress of pediatric narcolepsy and clinical value of video-electroencephalogram.
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Cerebral injury is a common disease in the pediatric intensine care unit(PICU)and the neonatal intensive care unit (NICU).Video-electroencephalogram examination can help for the etidogical diagnosis,illness monitoring and prognosis assessment.The article is a review about the applications of video-electroencephalogram in common diseases in NICU and PICU.
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Objective To determine whether the fixation method of electrode of the improved pediatric video electroencephalogram (VEEG) is better than the traditional fixation method. Methods A total of 746 children patients who needed VEEG monitoring were divided into the experimental group and the control group with random digit table with 373 patients in each group. Improved fixation method and traditional fixation method of electrode were adopted during VEEG monitoring in the experimental group and the control group. The advantage and disadvantage of the two fixation method were compared through evaluation of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage. Results The incidence of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage in the experimental group were 7, 0, 29, and 12, which were less than 29, 6, 71, and 37 of the control group, the differences were of statistical significance (χ2=14.126, 20.371, 13.652, P<0.01 or 0.05). Conclusions Improved electrode fixation method during pediatric VEEG can avoid skin injury of scalp and deltoideus triangularis, reduce electrode loss and electrode breakage, besides, it also can reduce medical cost and discomfort of children. The modified electrode fixation method proved to be superior to the traditional method and it is worth popularization and application.
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Objective To explore the cooperation of video electroencephalogram (VEEG) and nursing in the use of correcting iatrogenic refractory epilepsy in children.Methods We implemented the following nursing measures:making an appointment to understand the patients' history and seizures; controlling the condition of VEEG seriously to reduce the interference of potential difference; performing the recording of the background wave of the VEEG with eyes test,hyperventilation,flash stimulation and other evoked tests; giving experiment to induce seizure,such as vertical test,hot water stimulation and so on,which was according to the characteristics of children with seizures; informing the parents and children to review the VEEG and perfect the relevant inspection to correct the diagnosis of epilepsy clearly.Results 5 patients in 9 cases had corrected the diagnosis and classification of epilepsy.2 cases who had been diagnosed as BECT (benign childhood epilepsy with centrotemporal spikes) appeared new type of seizure in the course of disease,then we diagnosed the variant of BECT,according to the characteristics of VEEG.2 cases were excluded the diagnosis of epilepsy.Conclusions During application of VEEG in the use of correcting iatrogenic refractory epilepsy in children,we should pay attention to the communication with children and parents,strictly implement monitoring standard,give testing stimulation according to characteristics of children,so that we can get real and satisfying monitoring results.
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Objective To explore the clinical features and video-electroencephalogram (VEEG) monitoring of nonconvulsive status epilepticus (NCSE) in children.Methods 1.Object of study:Seventeen patients of NCSE diagnosed with Kaplan's criteria were analyzed in Children's Hospital of Fudan University between Oct.2009 and Sep.2012.2.Data analysis:Data on demographics,etiology,clinical manifestation and response to clonazepam therapy were analyzed.3.Therapies:Clonazepam 0.05 mg/kg was intravenously injected twice a day.Treatment of poor efficacy patients was combined with other antiepileptic drugs.4.Therapeutic effect:Clinical assessment of cognitive improvement and VEEG monitoring of background activity or paroxysmal abnormalities were analyzed.Results Nine male and 8 female of 17 patients with NCSE were involved,from 11 months to ll.4-year old.The clinical attacks lasted ranging variously time from 4 hours to 3 months.Each patient had a prolonged change of consciousness,accompanied by psychological or behavioral changes.Definite medical causes were identified in 65％ (11/17 cases) of the patients.Secondary epilepsy was the dominating cause.The characteristics of ictal VEEG in NCSE generally included slow activity and focal or generalized δ or θ activity.After clonazepam treatment,the conditions of 13 patients were under complete control,in which 4 had improvement.Six cases of unknown cause were fully controlled within 72 hours after intravenous injection of clonazepam.The prognosis of CNS infection sequelae patients,metabolism disorders and brain structural damage was poor.Conclusions NCSE may present with confusion,behavioral disturbances and psychiatric conditions.The diagnosis can be made by the ictal and interictal VEEG monitoring.It is necessary to make the diagnosis and control the seizures as quickly as possible.Clonazepam is useful in NCSE.
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Objetivo: mostrar los resultados de la introducción del video-electroencefalograma en la evaluación de los eventos paroxísticos neurológicos de naturaleza no precisada y/o en la epilepsia de difícil control en pacientes pediátricos. Métodos: se estudiaron 121 niños (edad 5,90 ± 4,34 años), divididos en 4 grupos atendiendo a la finalidad del estudio de video-electroencefalograma: I. Determinar la naturaleza (epiléptica o no) del evento paroxístico; II. Confirmar el síndrome epiléptico; III. Cuantificar las crisis epilépticas y IV. Estudiar candidatos para cirugía de la epilepsia. Resultados: la eficacia diagnóstica fue de un 86,77 %, y provocó modificaciones en el diagnóstico y/o el tratamiento inicial en un 32,38 %. Las modificaciones en el diagnóstico en el grupo I fueron en 16/43 pacientes (2 epilepsias, 7 trastornos del movimiento, 4 trastornos del sueño y 3 crisis psicógenas). En el grupo II se clasificaron 47 síndromes epilépticos (11 epilepsias focales, 31 epilepsias generalizadas y 5 indeterminadas). Para el grupo III el número de crisis registradas fue 7,31 ± 4,21, y el tiempo de registro del video-electroencefalograma fue de 3,86 ± 1,10 horas. En el grupo IV se estudiaron 2 pacientes, y se confirmaron como candidatos para hemisferectomía funcional. Conclusiones: el monitoreo por video-electroencefalograma ratificó ser una herramienta de gran valor y utilidad en el diagnóstico de los eventos paroxísticos neurológicos en niños, lo que incide en establecer una adecuada conducta terapéutica y contribuye a disminuir ciertas limitaciones en la aplicación de los criterios de la Liga Internacional contra la Epilepsia.
Objective: to show the results of the use of video electroencephalogram in the evaluation of undetermined neurological paroxysmal events and/or difficult epilepsy in pediatric patients. Methods: one hundred and 21 children (aged 5.90 ± 4.34 years), divided into 4 groups according to the objective of the video-EEG based study, were researched on. This study was aimed at 1) determining the nature of the paroxysmal event -either epileptic or not-; 2) confirming the epileptic syndrome; 3) quantifying the epileptic attacks; and 4) studying candidates for epilepsy surgery. Results: the diagnostic efficacy was 86.77 % and caused changes in diagnosis and/or in the initial treatment in 32.38 % of cases. Changes in diagnosis of group I occurred in 16 out of 43 patients (2 epilepsies, 7 movement disorders, 4 sleeping disorders and 3 psychogenic crises). Forty seven epileptic syndromes were classified in the second group (11 focal epilepsy, 31 generalized epilepsy and 5 undetermined). The number of recorded crises was 7.31 ± 4.21 in the third group and the video-EEG recording time was 3.6±1.10 hours. Two patients in the fifth group were studied and confirmed as candidates for functional hemispherectomy. Conclusions: video-electroencephalogram monitoring ratified that it is a very useful tool in the diagnosis of neurological paroxysmal events in children, which influences in setting a proper therapeutic behaviour and in assisting in the reduction of certain restrictions for the application of the International League against Epilepsy criteria.
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ObjectiveTo investigate the significance of clinical feature in the source localization of epileptogenic zone in children with frontal lobe epilepsy.MethodsThirty children who were diagnosed frontal lobe epilepsy consecutively admitted to the pediatric department of Shengjing hospital from Oct 2010 to Jun 2011 were recruited for retrospective study.All the cases were subject to video-electroencephalogram monitoring.Results Seventy-six episodes with clear origins of the electroencephalogram were monitored in 30 cases,including orbital frontal attack 11 times (14.5％),dorsolateral frontal attack 33 times (43.4％),mesial frontal attack 32 times (42.1％ ).The correlation analysis showed that the head and eye deviation (47 times,61.8％ ),asymmetric tonic seizures (32 times,42.1％ ) and parakinesia seizures (29 times,38.2％ ) prompted the focus was located in the dorsolateral frontal and mesial frontal.But there was no significant difference between the two areas ( x2 =10.58,9.67,11.55,P ＞0.05).The vocalization,manual pedal automatism and emotional seizure prompted the focus was located in the dorsolateral frontal and orbitofrontal;and the emotional seizure was significant differences between the two areas(x2 =38.68,P ＜0.001 ).Emotional seizure was the characteristic of orbitofrontal attack.Conclusion The clinical features have important significance in the judgment of the source localization of epileptogenic zone in children with frontal lobe epilepsy.The emotional seizure could be considered as the characteristic attack of orbitofrontal.
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0.05).Of essay group 19 children whose PET were normal or slight abnormal,8 children's VEEG had epileptifrom abnormalities only appear in lucid interval,8 children's VEEG had epileptifrom abnormalities appear in nocturnal sleep period,3 children's VEEG had epileptifrom abnormalities appear in lucid interval and nocturnal sleep period.Of essay group,7 children whose PET were serious abnormal,6 children's VEEG had epileptifrom abnormalities appear in lucid interval and nocturnal sleep period.The PET outcome was relate with the time of VEEG epileptic discharge(r=0.461 P
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Objective To evaluate the clinical significance of video-electroencephalogram(VEEG) in the diagnosis of paroxysmal events in children.Methods The VEEG and routine electroencephalogram(EEG) were used to inspect 262 cases of seizures respectively collected of outpatient clinic and admission department from Apr.2006 to Dec.2007,and VEEG monitoring results were analyzed and compared with primary diagnoses retrospectively.According to the characteristics of EEG and clinical observation to decide whether it be epilepsy or not and compare the difference between the results of EEG and VEEG to evaluate the application value of the 2 examination methods in children with NES.SPSS 13.0 software was used to analyze the data.Results Of all 262 cases,113 cases of clinical outbreak were recorded,meanwhile the diagnose of 4 patients of epileptic seizures(ES) group were changed to non-epileptic seizures(NES) and 3 patients of NES were rediagnosed to ES,69 cases couldn′t be confirmed according to VEEG or EEG and there was no outbreak recorded in the other 149 cases.In the period onset,79 children′s characteristics of EEG were captured which included 76 children in ES group,and 3 children in NES group.Thirty-six children′s characteristics of EEG were not captured which included 4 children in ES group and 30 children in NES group.The differences of the ratio of total detect and abnormity between EEG and VEEG were significant,improving the diagniosis rate and the control rate of symptom.VEEG had a clinical significance in differential diagnosis of ES and NES.Conclusions Compared with EEG,VEEG will be more helpful in diagnosing and differentiating seizures diseases,improving the diagnosis rate and the control rate of symptom.VEEG has a clinical in diffe-rential diagnosis for ES and NES.
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Objective To exlore clinical characteristics and changes of electroencephalography(EEG) in children with migraine.Methods Clinical data of 98 children with migraine provided by our hospitals clinic service were analysed.The cases′ history were inquired,physical examination made(EEG),Video-EEG(V-EEG) and transcranial doppler sonography(TCD) were examined.After(diagnosis) was made,the patients were treated and followed up.Results In 98 cases of migraine,27 cases were classical migraine and 71(cases) were ordinary migraine.EEG and V-EEG indicated most of them were in normal range and increase in diffused inactive echoes,and only 1 case of 98 EEG showed scattered epileptic waves;TCD indicated that the velocities of blood flow of intracranial arteries of 87 children with migraine were faster.Conclusions Clinical characteristics of children with migraine is similar with adault.Diagnosis of children with migraine and epilepsy,apply both EEG and TCD have great value in diagnosis of children with migraine.