EEG abnormalities in children with a first unprovoked seizure.
We examined EEG findings from an ongoing study of 347 children with a first unprovoked seizure. EEGs were available in 321 (93%), and 135 (42%) had an abnormal EEG. EEG abnormalities included focal spikes (n = 77), generalized spike and wave discharges (n = 28), slowing (n = 43), and nonspecific abnormalities (n = 7). Abnormal EEGs were more common in children with remote symptomatic seizures (60%) than in those with idiopathic seizures (38%) (p < 0.003), more common in partial seizures (56%) than in generalized seizures (35%) (p < 0.001), and more common in children age > 3 years (52%) than in younger children (12%) (p < 0.001). Records including both awake and sleep tracings were available in 148 (46%) cases. For 122 (38%) only awake tracings and for 51 (16%) only sleep tracings were available. Fifty-nine (40%) of the 148 patients with both an awake and asleep tracing had abnormal EEGs. Of 50 such EEGs with epileptiform abnormalities, 15 (30%) demonstrated the abnormality either only while awake (n = 8) or only while asleep (n = 7). Of 17 patients with EEG slowing, 8 showed slowing only in the awake tracing and 9 showed slowing in both the awake and asleep tracing. Children with even a single unprovoked seizure have a high incidence of EEG abnormalities. Obtaining a combined awake and sleep EEG significantly increases the yield of EEG abnormalities. In children with an idiopathic first seizure, EEG abnormalities are associated with an increased risk of seizure recurrence.
Shinnar
S
S
Department of Neurology, Montefiore/Einstein Epilepsy Center, Albert Einstein College of Medicine, Bronx, NY.
Kang
H
H
Berg
A T
AT
Goldensohn
E S
ES
Hauser
W A
WA
Moshé
S L
SL
D000293:Adolescent; D000367:Age Factors; D001921:Brain / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology; D012890:Sleep / Q000502:physiology; D014851:Wakefulness / Q000502:physiology