Differential diagnosis of staring spells in children: a video-EEG study.
Staring is frequently a nonepileptic manifestation in children. To differentiate epileptic versus nonepileptic staring, we reviewed clinical and video-EEG findings in 143 patients, aged 5 months to 43 years, monitored for staring episodes. In 79 patients staring was of epileptic origin; 46 had partial seizures and 33 atypical absence. Thirty-five had behavioral staring, 8 psychogenic seizures, 1 a migraine equivalent, and in 20 no staring spells were recorded. In all patients with epileptic staring, epilepsy was suspected clinically. Only 22 of the admissions for behavioral staring and 3 for pseudoseizures were to exclude a possible nonepileptic phenomenon. Review of their clinical histories revealed that certain findings strongly support a nonepileptic origin. In conclusion, a careful clinical history will differentiate between epileptic and nonepileptic staring episodes in most patients. Video-monitoring is helpful to adjust treatment or to exclude nonepileptic events in patients with refractory staring spells.
Carmant
L
L
Department of Neurology, Hôpital Ste-Justine, Montréal, Québec, Canada.
Kramer
U
U
Holmes
G L
GL
Mikati
M A
MA
Riviello
J J
JJ
Helmers
S L
SL
D000293:Adolescent; D000328:Adult; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005403:Fixation, Ocular; D006801:Humans; D007223:Infant; D008881:Migraine Disorders / Q000175:diagnosis; D008991:Monitoring, Physiologic / Q000379:methods; D012640:Seizures / Q000175:diagnosis; D013690:Television