Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1383
2
1
gregorian
2004
5
1
18
1
online
1
fulltext
en
USEFULNESS OF SLEEP-DEPRIVED EEG IN THE DIAGNOSIS OF SEIZURE DISORDERS IN CHILDREN
Pediatric
Pediatric
Original Research: Clinical Science
Original Research: Clinical Science
The provocative effects of sleep deprivation (SD) on patients with seizure disorder
and on the electroencephalogram (EEG ) are well known. The purpose of the study
was to test its routine use and usefulness in the pediatric and adolescent age group with,
or suspect of having, seizure disorder, especially those presenting with first unprovoked
seizure.
Between September 2000 and November 2002, among patients referring to the
author's clinic and the Pediatric Emergency Department of Nemazi Hospital, Shiraz,
598 children and adolescents were randomly assigned to a 10-minute surface EEG,
either routinely, or after a period of partial or total SD. Those who refused or could not
tolerate the SD procedure entered the routine group. The EEG's were analyzed for the
presence of epileptic abnormality.
Of598 patients ,5 44( 91 %) had clinical seizures the rest (54,9%) were seizure
suspects or had seizure "mimickers" ( syncope, night terrors, pseudo-seizures, etc). Of
seizure patients, 210 ( 38.6 % ) suffered from a first unprovoked seizure, and the rest
(334,61.4%) had more than one seizure episode at the time of EEG performance.
Abnormal epileptiform EEG's were more frequently seen in the group of seizure
patients who were sleep-deprived before performing the EEG, as compared to the
routine group. Conversely, more normal EEG's were seen upon routine performance
of EEG (p value <00001, X2 = 76.5).
Similarly, more abnormal sleep-deprived EEG's were seen in patients with first
unprovoked seizure than when EEG was done routinely in this subgroup of patients.
Patients with complex partial seizure had significantly more abnormal EEG's when subjected
to SD (p<0000 1).
Older patients could tolerate SD better than the younger age group so more
routine EEG's had to be performed in the younger age group. Younger children could
only tolerate partial SD. There was no difference in the yield of EEG in patients with
absence epilepsy between the two groups. In 5 patients with juvenile myoclonic epilepsy,
S D precipitated a generalized tonic-clonic seizure which necessitated acute antiepileptic
drug administration to the seizure activity.
All patients with non-seizure episodes showed normal EEG's.
In conclusion SD can be safely applied in the work-up of selected pediatric
patients with seizure disorder, especially in those with their ftrst unprovoked seizure, in
whom an abnormal EEG might dictate anti-epileptic drug therapy.
Not all children with seizure disorder need to undergo SD for EEG, as it may not
be necessary i n some, and intolerable in others. In non-seizure episodes, i f used in
appropriate pediatric age groups, it can be very helpful to ensure that a seizure disorder
is not present.
Seizure Disorder, Epilepsy, Electroencephalography(EEG), Sleep Deprivation (SD).
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http://mjiri.iums.ac.ir/browse.php?a_code=A-10-298-106&slc_lang=en&sid=1
SEYYED MOHAMMAD
RAFIEI
20031947532846003615
20031947532846003615
Yes
From the Department of Pediatric Neurology, Shiraz University of Medical Sciences, Shiraz, Iran