Diagnostic Utility of Specific Abnormal EEG Patterns in Children for Determining Epilepsy Phenotype and Presence of Structural Brain Abnormalities
Abstract number :
2.013
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2022
Submission ID :
2203939
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Mohammed Ashour, MD – Boston Children's Hospital; Erica Minato, M.S – Research Institute of the McGill University Medical Centre; Abdulla Alawadhi, MD, FRCPC – Division of Child Neurology, Department of Pediatrics, Montreal Children’s Hospital, McGill University; Saoussen Berrahmoune, PhD – Research Institute of the McGill University Medical Centre; Elisabeth Simard-Tremblay, MD, FRCPC – Division of Child Neurology, Department of Pediatrics, Montreal Children’s Hospital, McGill University; Chantal Poulin, MD, FRCPC – Division of Child Neurology, Department of Pediatrics, Montreal Children’s Hospital, McGill University; Kenneth Myers, MD, FRCPC – Division of Child Neurology, Department of Pediatrics, Montreal Children’s Hospital, McGill University
Rationale: Estimate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of EEG findings: centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, and asymmetric sleep spindles, for epilepsy phenotype and presence of structural brain abnormalities.
Methods: In this case-control study we reviewed children with EEGs over a 4-year period, with at least one of centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, or asymmetric sleep spindles. This cohort was analyzed in combination with a research database of pediatric patients with seizures.
Results: Centrotemporal spikes had 100% sensitivity for childhood epilepsy with centrotemporal spikes or atypical childhood epilepsy with centrotemporal spikes, but lower specificity (70%) and PPV (58%). Photoparoxysmal response had high specificity (92%) and NPV (92%) for genetic generalized epilepsy. Asymmetric photic driving had low sensitivity for structural brain abnormalities (17%), with specificity 80%. In contrast, asymmetric sleep spindles had much higher sensitivity and specificity, 44% and 97%, respectively.
Conclusions: Although centrotemporal spikes are classically associated with childhood epilepsy with centrotemporal spikes, these discharges are seen in other conditions. Photoparoxysmal response is highly indicative of a genetic generalized epilepsy, though may be seen in other epilepsy phenotypes. Relative attenuation of sleep spindles is a more reliable indicator of structural brain malformation than asymmetric photic driving. Significance The quantitative diagnostic utility of EEG findings should be considered when incorporating these results into clinical decision-making.
Funding: This work was supported by the Research Institute of the McGill University Health Centre; and Fonds de Recherches du Québec – Santé.
Neurophysiology