Epileptiform Discharges and Frontal Paroxysmal EEG Abnormality Act as Predictive Marker for Subsequent Epilepsy in Children With Complex Febrile Seizures

Background: Psychiatrists commonly use electroencephalogram (EEG) to rule out epilepsy as a cause of psychiatric symptoms. A large number of these studies are normal. Our study aims to identify the predictive factors of an EEG with epileptiform activity in these patients. Methods: We performed a retrospective study of the EEG results and chart reviews of the 208 psychiatric patients at Royal University Hospital in Saskatoon, Saskatchewan from 2013-2015. The EEG results were correlated with several factors known to increase the probability of an abnormal recording including history of seizures, previously abnormal EEGs, imaging abnormalities, medications known to cause epileptiform discharges, electroconvulsive therapy, prematurity, brain infection, childhood febrile seizures, head trauma, and family history. Results: Of the 208 EEGs performed, 176 (84%) were normal (77%) or essentially normal (7%). Epileptiform activity was found in 13 EEGs (6.3%), of which 9 (4.3%) had a previous EEG with epileptiform activity. Focal slowing appeared in 12 EEGs (5.8%), two of which had previous abnormal EEGs. Generalized slowing was found in 7 EEGs (3.4%). Conclusions: We conclude that the majority of EEGs in patients with psychiatric manifestations are normal. The most predictive factor for epileptiform activity in this population is a previous EEG with epileptiform discharges. Other predictive factors are under review.

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P.095 The many clinical facets of pediatric occipital spikes and the predictive value of consistent EEG dipole

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2021.373 ◽

2021 ◽

Vol 48 (s3) ◽

pp. S46-S46

Author(s):

AN Datta ◽

L Wallbank ◽

J Micallef ◽

PK Wong

Keyword(s):

Febrile Seizures ◽

Clinical Settings ◽

Clinical Predictors ◽

Seizure Onset ◽

Study Objective ◽

Epileptiform Discharges ◽

Symptomatic Epilepsy ◽

Neuro Imaging ◽

The Many ◽

Occipital Spikes

Background: Pediatric occipital epileptiform discharges (OEDS) occur in various clinical settings, including benign and symptomatic epilepsies. The study objective is to determine electro-clinical predictors for aetiology and prognosis in children with OEDs. Methods: 205 patients with OEDs were classified into seizure groups: symptomatic (n=98), idiopathic focal (IF) (n=57), idiopathic generalized (IG) (n=18), no-seizures (n=27) and febrile seizures (n=5). Results: The median age of seizure onset was 3 years (range: 0-19). There was more EEG background slowing (P<0.05) in the symptomatic; photosensitivity (P<0.0001) and GSW (P<0.0001) in IG; and presence of consistent EEG spike dipole in IF group. The symptomatic had more DD (P< 0.0001), autism (P <0.019), and school difficulties (P<0.001) than the IF and IG groups, but not different from the no-seizure group. Conclusions: OEDs with consistent dipole spike is predictive of IF epilepsy. In contrast to frontal and temporal lobe epilepsy, only 30% with symptomatic epilepsy had occipital-predominant neuro-imaging abnormalities. Notably, neuro-psychiatric co-morbidities were similar between the symptomatic and no-seizure group.

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Risk for developing epilepsy and epileptiform discharges on EEG in patients with febrile seizures

Brain and Development ◽

10.1016/j.braindev.2012.07.014 ◽

2013 ◽

Vol 35 (4) ◽

pp. 307-311 ◽

Cited By ~ 21

Author(s):

Saet Byul Wo ◽

Jun Hwa Lee ◽

Yong Ju Lee ◽

Tae-Jung Sung ◽

Kon Hee Lee ◽

...

Keyword(s):

Febrile Seizures ◽

Epileptiform Discharges

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Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Journal of Child Neurology ◽

10.1177/0883073818787064 ◽

2018 ◽

Vol 33 (12) ◽

pp. 772-775

Author(s):

Alja Kavčič ◽

Zvonka Rener-Primec

Keyword(s):

Positive Predictive Value ◽

Epileptic Seizure ◽

Predictive Value ◽

Epileptic Seizures ◽

Febrile Seizures ◽

Epileptiform Discharges

The predictive value of epileptiform discharges for subsequent epilepsy after febrile seizures was studied in 140 children: 72 children (51%) had simple febrile seizures and 68 children (49%) had complex febrile seizures. Electroencephalography (EEG) was performed in 103 children (74%), it was normal in 66 (47%) and with epileptiform patterns in 37 patients (26%). At follow-up in 2017, 10 children developed epilepsy, 1 had a single epileptic seizure, 9 of them had epileptiform EEGs. Of the patients with normal EEGs after complex febrile seizures, none developed epilepsy, and 92% of patients with normal EEGs after recurrent febrile seizures did not develop epilepsy. Therefore, patients with normal EEGs were unlikely to develop epilepsy. Fifteen percent of patients with complex and 31% of patients with recurrent febrile seizures and epileptiform EEGs developed epileptic seizures. The positive predictive value of epileptiform discharges was low in complex and twice as high in recurrent febrile seizures.

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A study of prevalence of abnormal EEG and its association between various clinical presentations of atypical febrile seizures

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205517 ◽

2020 ◽

Vol 8 (1) ◽

pp. 120

Author(s):

Bruntha Priyavathani J. ◽

Sriram Pothapregada ◽

Anuradha Varadhan ◽

Suresh C. Thirunavukarasu

Keyword(s):

Clinical Features ◽

Febrile Seizure ◽

Age At Onset ◽

Predictive Marker ◽

Febrile Seizures ◽

Quantitative Eeg ◽

Clinical Presentations ◽

Long Term Follow Up ◽

Eeg Recordings

Background: Quantitative EEG is a rapidly emerging tool in the diagnosis and follow up of various neurological disorders and can act as predictive marker for subsequent epilepsy in children with complex febrile seizure. The present study aimed to estimate the prevalence of abnormal electroencephalogram (EEG) and to find the association between Quantitative EEG (qEEG) and various clinical features of atypical febrile seizures(AFS).Methods: EEG was recorded along with clinical features including the age at onset, duration of episode, number of episodes in a day, type of seizure and the recurrences from the children aged between 6-60 months with atypical febrile seizures. EEG recordings were classified into Normal and abnormal EEG with epileptiform changes by the expert interpretation and the distribution of above said clinical features in the both groups were analyzed. It is also attempted to find the association between qEEG and few of the clinical features.Results: Prevalence of abnormal EEG in atypical febrile seizures was 33.9%. There were no significant differences in the distribution of abnormal EEG and their association with various clinical features of AFS. Significantly increased absolute power of θ and α waves were recorded from the frontal montages in the children with epileptiform changes in the EEG.Conclusions: qEEG changes can be also considered as marker of severity of febrile seizure episodes. Many prospective studies with long-term follow up are required to establish the predictability of future epilepsy by qEEG.

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