Abstracts

RATIONALE: The use of video-EEG monitoring in adults with paroxsymal events is well established. It has been shown to be very useful in distinguishing non-epileptic from epileptic events. This study aims to determine the utility of this monitoring technique in children with paroxysmal events. METHODS: We reviewed the medical records of all pediatric patients who were admitted to the Epilepsy Monitoring Unit (EMU) from June 1995 to February 2000. The patients underwent continuous video-EEG monitoring. The paroxysmal events were recorded, analyzed,and classified as either epileptic or non-epileptic based on clinical manifestations and EEG correlate. RESULTS: One hundred and seventy four children were admitted to the EMU during this period of time. Ages ranged from 3 mo. to 18 years old, 94 males and 80 females. The breakdown by admitting diagnosis was as follows; 68 patients presented with staring spells, 53 had history of myoclonic jerks, 37 had history of generalized tonic-clonic seizures, 20 had history of altered levels of consciousness, 60 had various diagnosis, including rage attacks, limb jerking, unresponsiveness. Duration of admission ranged from 1-19 days, with an average of 4.5 days. Typical events were recorded for 152 patients (87%), 17 patients had no events during their admissions. Of those patients who had typical events recorded, 89 (58%) had non-epileptic events; of these, 50 (45%) were on anticonvulsant medications. Sixty-eight patients were found to have epileptic seizures. Eighteen patients (10%) of all those who had typical events recorded had both epileptic and non-epileptic events. CONCLUSIONS: Our experience shows that video-EEG monitoring can be extremely useful in the characterization and classification of paroxsymal events in children. This monitoring has a high degree of accuracy in differentiating epileptic from non-epileptic events, thus making the subsequent management of these children more effective.