The diagnostic role of short duration outpatient V-EEG monitoring in children

Valente, Kette D; Freitas, Alessandra; Fiore, Lia A; Gronich, Gary; Negrão, Nubio

doi:10.1016/S0887-8994(03)00002-X

« Previous Next »Pediatric Neurology
Volume 28, Issue 4 , Pages 285-291, April 2003

The diagnostic role of short duration outpatient V-EEG monitoring in children

Kette D Valente, MD, PhD
- Communications should be addressed to: Dr. Valente; Laboratory of Clinical Neurophysiology; Institute and Department of Psychiatry; University of São Paulo Medical School; R. Jesuíno Arruda, 901; Apartment 51; 04532 082 São Paulo, SP Brazil
- Laboratory of Clinical Neurophysiology, Department and Institute of Psychiatry, São Paulo, Brazil
Alessandra Freitas, MD
- Laboratory of Clinical Neurophysiology, Department and Institute of Psychiatry, São Paulo, Brazil
- Department of Pediatrics, University of São Paulo, São Paulo, Brazil
Lia A Fiore, MD
- Laboratory of Clinical Neurophysiology, Department and Institute of Psychiatry, São Paulo, Brazil
Gary Gronich, MD
- Laboratory of Clinical Neurophysiology, Department and Institute of Psychiatry, São Paulo, Brazil
Nubio Negrão, MD
- Laboratory of Clinical Neurophysiology, Department and Institute of Psychiatry, São Paulo, Brazil

Received 9 July 2002; accepted 23 November 2002.

Abstract

Video-electroencephalographic monitoring enables correlation between behavioral and EEG data, however, because it requires prolonged hospitalization, it may be stressful and expensive. This study aimed to assess the benefits and limitations of this procedure in children. We analyzed 39 children classified according to clinical complaints: doubts about epilepsy classification in 23 (Group I); differential diagnosis with nonepileptic events in eight (Group II); and differential diagnosis between cognitive decline and subtle seizures in eight (Group III). Clinical episodes were recorded in 37 patients (94.9%). In Group I, seizure type was reclassified in 11 patients and epileptic syndrome in nine. In two patients a previously unnoticed seizure type was recorded. In Group II, four patients presented epileptic seizures. In Group III, nonconvulsive status was detected in five. Video-electroencephalographic monitoring enabled major modification of therapeutic approach in 21 patients and guided new neuroimaging studies in 10 patients. In conclusion, in patients with frequent seizures, short video-electroencephalographic monitoring allows proper classification of epileptic syndromes, and diagnosis of nonepileptic seizures, promoting introduction of appropriate treatment with a relatively low cost.