Abstracts

The significance of Generalized Periodic Discharges (GPDs), also known as generalized periodic [ldquo]epileptiform[rdquo] discharges (GPEDs), is unknown in the pediatric population. The purpose of this study was to determine the frequency and clinical significance of GPDs in children and their association with seizures., All patients found to have GPDs on continuous EEG monitoring (CEEG) between 01/2000 and 05/2006 were retrospectively identified. We then reviewed the demographic data, etiology, medications, occurrence of seizures (convulsive and nonconvulsive), status epilepticus (SE), and clinical outcome., Among 900 pediatric patients who underwent EEG/video monitoring, twelve were found to have GPDs. None of the patients was identified with isolated triphasic waves. Mean age was 8.9 years (3 months to 18 years). Four were males and eight were females. Five had a history of epilepsy, three had viral encephalitis, four had metabolic etiologies, one had anoxic-ischemic injury and one had intracranial hemorrhage. All patients had convulsive seizures prior to the diagnosis of GPDs. Seizures occurred in 10 patients following the recognition of GPDs. Additionally, 10 patients had non-convulsive seizures and 8 were in SE. At the time of diagnosis of GPDs, 8 (67%) were on barbiturates or midazolam infusion. Three patients died. Two patients were still in non-convulsive status epilepticus at the time of death. Four patients had favorable outcome with mild disability and the rest had moderate to severe disability., Clinical features and outcome of GPDs are different in children. It was found that in adults, almost half of patients with GPDs do not have associated seizures. However in children we noted that GPDs are always associated with convulsive seizures and /or SE. Continuous EEG/video recording is valuable for the diagnosis of this EEG pattern and to optimize and monitor the efficacy of the treatment.,