[The electroencephalogram: a complementary test that should not be forgotten to perform before a first seizure]. / El electroencefalograma: una prueba complementaria que no debe olvidarse realizar ante una primera crisis epiléptica.

TITLE: El electroencefalograma: una prueba complementaria que no debe olvidarse realizar ante una primera crisis epiléptica.

[Electroencephalographic alterations in children with attention deficit hyperactivity disorder]. / Alteraciones electroencefalograficas en ni os con trastorno por deficit de atencion con hiperactividad.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a syndrome that affects between 3 5% of the population of school aged children, and may be accompanied by learning, language, behavioural or motor disorders. Although various electroencephalographic alterations have been described in these patients, their pathological significance has not been determined. There have also been reports of children with neuropsychological and language disorders having epileptiform anomalies in the EEG recording. PATIENTS AND METHODS: We conducted a study of 15 children, with no history of seizures, who had been referred to Child Neurology for treatment and who satisfied the criteria for ADHD according to the DSM IV and the ADHRS (attention deficit/hyperactivity rating scale). RESULTS: The EEG recording in the waking state showed significant anomalies in two of our patients (acute spike and wave paroxysmal activity in the left temporoparietal region and spike wave discharges during hyperventilation). The polysomnographic study revealed specific alterations in four children. There was a continuous spike wave trace during slow sleep (CSWS) in one case, paroxysmal activity (slow acute waves, spikes) in the temporoparietal region with secondary generalization or transmission (two cases), and frequent generalized paroxysmal discharges of slow acute waves in all phases of sleep (one case). CONCLUSIONS: The neurophysiological disorders observed in some of our patients could make it necessary to consider performing a night time polysomnographic study in certain cases of ADHD.

Alteraciones electroencefalográficas en niños con trastorno por déficit de atención con hiperactividad / Electroencephalographic alterations in children with attention deficit hyperactivity disorder

Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) es una entidad nosológica que afecta al 3-5 por ciento de la población infantil en edad escolar, y puede ir acompañada de trastornos de aprendizaje, de lenguaje, conductuales o motores. Aunque se han descrito diversas alteraciones electroencefalográficas en estos pacientes, no se ha determinado su significación patológica. Por otro lado, se ha referido que los niños con trastornos neuropsicológicos y del lenguaje pueden tener anomalías epileptiformes en el EEG. Pacientes y métodos. Se han estudiado 15 pacientes remitidos a la consulta de Neurología infantil, sin antecedentes de crisis convulsivas, que cumplían los criterios del TDAH según el DSM-IV y la EDAH (escala de déficit de atención con hiperactividad). Resultados. El EEG en vigilia mostró anomalías significativas en dos de nuestros pacientes (actividad paroxística de puntas y ondas agudas en la región temporoparietal izquierda y descargas de punta-onda durante la hiperventilación). En el registro polisomnográfico observamos alteraciones específicas en cuatro niños: un trazado de punta-onda continua durante el sueño lento (POCS) en un caso; actividad paroxística (puntasondas agudas y lentas) en la zona parietotemporal con transmisión o generalización secundaria (dos casos), y frecuentes descargas paroxísticas generalizadas de ondas lentas y agudas en todas las fases del sueño (un caso). Conclusión. Las alteraciones neurofisiológicas observadas en algunos de nuestros pacientes podrían plantear la necesidad de realizar una polisomnografía nocturna en determinados casos de TDAH (AU)

Introduction. Attention deficit hyperactivity disorder (ADHD) is a syndrome that affects between 3-5% of the population of school-aged children, and may be accompanied by learning, language, behavioural or motor disorders. Although various electroencephalographic alterations have been described in these patients, their pathological significance has not been determined. There have also been reports of children with neuropsychological and language disorders having epileptiform anomalies in the EEG recording. Patients and methods. We conducted a study of 15 children, with no history of seizures, who had been referred to Child Neurology for treatment and who satisfied the criteria for ADHD according to the DSM-IV and the ADHRS (attention deficit/ hyperactivity rating scale). Results. The EEG recording in the waking state showed significant anomalies in two of our patients (acute spike and wave paroxysmal activity in the left temporoparietal region and spike-wave discharges during hyperventilation). The polysomnographic study revealed specific alterations in four children. There was a continuous spike-wave trace during slow sleep (CSWS) in one case, paroxysmal activity (slow acute waves, spikes) in the temporoparietal region with secondary generalization or transmission (two cases), and frequent generalized paroxysmal discharges of slow acute waves in all phases of sleep (one case). Conclusions. The neurophysiological disorders observed in some of our patients could make it necessary to consider performing a night-time polysomnographic study in certain cases of ADHD (AU)