Electroencephalography in pediatric moyamoya disease: reappraisal of clinical value.
OBJECTIVE
The clinical value of electroencephalography (EEG) in pediatric moyamoya disease has been underestimated, though the characteristic patterns are well known. We undertook this study to evaluate the clinical value of EEG as a diagnostic and postoperative follow-up modality in pediatric moyamoya disease.


METHODS
We retrospectively reviewed the pre and postoperative EEG with effective hyperventilation in 127 pediatric moyamoya patients and compared their patterns with hemodynamic images.


RESULTS
One hundred and two patients (80.3 %) among 127 showed abnormal EEG findings before revascularization surgery. The typical rebuild-up phenomenon was observed in 82 (64.6 %) and localized build-up in 32 (25.2 %) without any significant clinical ischemic events during and after hyperventilation. The rebuild-up was observed more frequently in younger age groups (less than 13 years) and Suzuki stages III. The location of the rebuild-up distribution and asymmetric build-up was consistent with the area showing hemodynamic abnormalities on single photon emission computed tomography and/or perfusion magnetic resonance imaging. Postoperative follow-up EEGs were performed in 41 patients. Six patients with remaining rebuild-up in postoperative follow-up EEG showed poorer postoperative clinical outcomes.


CONCLUSIONS
This study may reappraise EEG as an easy, safe, and adjunctive diagnostic and postoperative follow-up modality for evaluation of hemodynamic status and clinical outcome, especially in children with moyamoya disease.
Division of Pediatric Neurology, Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
Anna
A
Cho
Jong-Hee
JH
Chae
Hun Min
HM
Kim
Byung Chan
BC
Lim
Hee
H
Hwang
Yong Seung
YS
Hwang
Ji Hoon
JH
Phi
Seung-Ki
SK
Kim
Kyu-Chang
KC
Wang
Byung-Kyu
BK
Cho
Ki Joong
KJ
Kim
D000293:Adolescent; D017668:Age of Onset; D000375:Aging / Q000502:physiology; D002545:Brain Ischemia / Q000209:etiology; D002648:Child; D018450:Disease Progression; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000601:surgery; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome