Paroxymal Disorders in Infancy (ages 1 – 24 Months): Establishing a Prediction Tool for Determining Seizure Likelihood
Abstract number :
1.204
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2021
Submission ID :
1826617
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:55 AM
Authors :
Melisa Carrasco McCaul, MD/PhD - University of Wisconsin; Theresa Estiphan - University of Michigan; Nancy McNamara - University of Michigan
Rationale: Various paroxysmal disorders in infancy are common and may raise alarm for possible seizures. However, there are age-related epilepsies that affect infants in whom timely diagnosis is imperative, such as in infantile spasms. It can be difficult to determine whether a paroxysmal behavior represents a seizure or a non-epileptic event. This study aims to evaluate the diagnostic yield of continuous video EEG (cVEEG) monitoring for the characterization of events concerning for seizures in a cohort of children ages 1 - 24 months old.
Methods: We performed a single-center retrospective chart review (2019 - 2021) and included all children ages 1 – 24 months whose EEG reports listed a “spell” concerning for seizure as a primary reason for obtaining a cVEEG. Chart abstraction included: demographics, history of neonatal injury, neurological exam abnormality on admission, known structural brain abnormality, and family history. The odds ratios of the different variables for predicting whether an event captured on cVEEG was a seizure were determined.
Results: On cVEEG, N = 28 (68%) patients had nonepileptic events captured, while N = 13 (32%) had epileptic seizures, including infantile/epileptic spasms. Please refer to Table 1 for a summary of the semiology of the patients’ events. Refer to Table 2 for the odds ratios of selected patient variables for conferring risk for seizures or epileptic spasms.
Conclusions: Patients with a history of neonatal injury, documented neurological exam abnormality, and positive family epilepsy history were 6, 11.5 and 1.42 times more likely to have a confirmed seizure on cVEEG, respectively. Our findings are of special significance, as our study provides insight into which patients should be prioritized to undergo cVEEG for spell characterization between ages 1 – 24 months. Future efforts will aim to develop a risk stratification tool that will help prioritize which infants should undergo emergent cVEEG.
Funding: Please list any funding that was received in support of this abstract.: None.
Clinical Epilepsy