Electrographic Features and Predictive Value of EEG in Children with Complex Febrile Seizures
Abstract number :
2.023
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2021
Submission ID :
1825665
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Purva Choudhari, MD - UT Southwestern; Alison Dolce, MD - Assistant Professor, Division of Pediatric Neurology, UT Southwestern; Andrea Lowden, MD - Assistant Professor, Division of Pediatric Neurology, UT Southwestern
Rationale: Febrile seizures are a common illness in children that occurs between the ages of 6 months to 5 years.1 Although there is an increased risk of future epilepsy in children with complex febrile seizures (CFS), there is limited research on the role of specific epileptiform discharges in these children for prognostication and the results have been conflicting.1 Our study sought to determine the predictive value of EEG for the development of epilepsy, with a focus on localization of epileptiform discharges and timing of EEG acquisition.
Methods: We performed a retrospective study of patients, seen between 2009 to 2019 at our tertiary care institution, who had CFS, underwent EEG, and had minimum one year of follow-up. Electronic medical records for 1376 children with the diagnosis code of CFS were reviewed and those who met our inclusion criteria (including normal development or mild delay and no previously known brain abnormalities) were included in the study. Statistical analysis was performed using SAS.
Results: 243 patients met inclusion criteria (with follow-up ranging from 14 months to 11 years). 14.4% of these patients had epileptiform discharges on EEG. Of these children, 54% had discharges localized to the midline-vertex region, which was significantly greater (p = 0.0002) than children with another localization. 32% of the patients with epileptiform discharges developed epilepsy. Children who developed epilepsy had varying localizations of discharges (see Figure). Of children with midline-vertex discharges, 45% developed epilepsy and 55% did not. 17% of children who underwent “early” EEGs (< 7 days after the CFS) had epileptiform discharges compared to 9% of children who underwent “late” EEGs ( >= 7 days after the CFS). However, similar percentages (33% and 34% respectively) of children with early and late EEGs with epileptiform discharges developed epilepsy. A logistic regression model identified number of febrile seizures during 24 hours, presence of epileptiform discharges, family history of afebrile seizures, and age of CFS onset as significant predictors for epilepsy development (p < 0.05 for each factor).
Neurophysiology