Dynamic electroencephalogram monitoring in evaluation of paroxysmal cerebral disorder in children

Yuzhen ZHOU

ABSTRACT

BACKGROUND:

Twenty-four hours dynamic electroencephalogram (EEG)is to prolong the time of scanning on the basis of routine EEG to monitor electrical activity of brain in various states, by which, the detectable rate of epilepsy is much improved in children.

OBJECTIVE:

To probe into the evaluation of 24 hours dynamic EEG monitoring on paroxysmal cerebral disorder in children in epileptic and suspected epileptic patients.

DESIGN:

Case analysis.

SETTING:

Department of Neurological Internal Medicine of Second Affiliated Hospital of Jiangxi Medical College.

PARTICIPANTS:

Totally 151 cases of paroxysmal cerebral disorder were employed, diagnosed in clinic and from the inpatients in Department of Neurological Internal Medicine of Second Affiliated Hospital of Jiangxi Medical College from July 2001 to October 2004, of which, 99 cases were male, 52 cases female, aged varied from 3 month to 14 years. According to clinical diagnosis, two groups were divided, named epileptic group (85 cases) and suspeeted epileptic group (66 cases). Of 151 eases, 39 cases received EEG examination, 21 cases CT scanning examination and 3 cases MRI examination.

METHODS:

All of participants were inquired medical history in detail,received physical examination in Neurological Department and 24 hours dynamic EEG monitoring [those were determined as epileptic discharge if during the monitoring, it was present spike wave, sharp wave, spike and ware complex, burst high-amplitude slow wave, high-arrhythmic wave,neonatal single rhythmic burst wave and hyperventilation early breakthrough or limitative burst slow wave. Those were determined as non-specific abnormality if it was present abnormal background wave, occipital paroxysmal slow wave of childhood, extreme spindle wave of sleep stage,neonatal diffusive transient sharp wave and occasional non-classic sharpslow complex.]. In addition, the results of routine EEG, CT or MRI examinations were collected.epileptiform discharge of paroxysmal disorder in children during 24 hours of abnormal rate and epileptiform discharge of paroxysmal disorder in children during 24 hours dynamic EEG monitoring with the results of routine EEG, CT or MRI examinations.dynamic EEG monitoring, of 151 cases, abnormality was present in 122cases, of which, 97 cases had epileptiform discharge. The epileptiform discharge rate in epileptic group was higher remarkably in suspected epileptic tic group, epileptiform discharge in dynamic EEG was mainly in unilateral hemisphere or dominant in limitative unilateral side and bilateral cerebral hemisphere. In suspected epileptic group, the detectable rate of epileptiEpileptiform discharge was predominated in sleep period (74%, 72/92), of peared clinic seizure in epileptic group, of which, the detectable rate epileptiform discharge was 93% (13/14), higher remarkably than suspected epileptic group [25 cases of clinic seizure, epileptiform discharge decases received routine EEG examination, of which, 19 cases were present non-specific abnormality and 7 cases had epileptiform discharge; in dynamic EEG examination, 5 cases were present non-specific abnormality and 29 cases had epileptiform discharge. In comparison, non-specific abnormality was dominant in routine EEG and epileptiform discharge was predominated in dynamic EEG.

CONCLUSION:

Twenty-four hours dynamic EEG examination results in remarkable high detectable rate of epileptiform discharge in diagnosis of paroxysmal disorder in children and determines discharge location and time, indicating fully the advantage of dynamic EEG in evaluation of paroxysmal cerebral disorder in children.