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Role of Video-EEG in Children

  • Review Article
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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Routine electroencephalogram (EEG) has many limitations, especially the inability to capture reported habitual events in question. A prolonged EEG with synchronized video (video-EEG) overcomes some of these limitations by improving the sensitivity, specificity and the diagnostic yield by attempting to record the habitual events when they are frequent and when indicated. Video-EEG is employed commonly for the diagnosis and classification of epilepsy/epilepsy syndromes, to distinguish between seizures and seizures mimickers, for pre-surgical evaluation and in the management of critically ill children. The duration of recording would vary depending on the indication and frequency of events. Ambulatory EEG is another cost effective and convenient alternative in certain circumstances. However, availability of the machines and expertise, accessibility, affordability and labor intensive nature of the procedure limit widespread use in India. This review explores the role of video-EEG in the management of children with epileptic and non-epileptic paroxysmal events with respect to routine clinical practice in India.

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References

  1. Chadwick D. Diagnosis of epilepsy. Lancet. 1990;336:291–5.

    Article  CAS  PubMed  Google Scholar 

  2. Stroink H, van Donselaar CA, Geerts AT, Peters ACB, Brouwer OF, Arts WFM. The accuracy of the diagnosis of paroxysmal events in children. Neurology. 2003;60(6):979–82.

    Article  CAS  PubMed  Google Scholar 

  3. Uldall P, Alving J, Hansen LK, Kibæk M, Buchholt J. The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events. Arch Dis Child. 2006;91(3):219–21.

  4. Nagy E, Major A, Farkas N, Hollódy K. Epileptic seizure or not? Proportion of correct judgement based only on a video recording of a paroxysmal event. Seizure. 2017;53:26–30.

    Article  PubMed  Google Scholar 

  5. Tatum WO. EEG interpretation: common problems. Clin Pract. 2012;9(5):527–38.

    Article  CAS  Google Scholar 

  6. Asano E, Pawlak C, Shah A, et al. The diagnostic value of initial video-EEG monitoring in children—review of 1000 cases. Epilepsy Res. 2005;66(1):129–35.

    Article  PubMed  Google Scholar 

  7. Koc G, Morkavuk G, Akkaya E, et al. Latencies to first interictal epileptiform discharges in different seizure types during video-EEG monitoring. Seizure. 2019;69:235–40.

    Article  PubMed  Google Scholar 

  8. Hisatomi A, Faulkner HJ, Mohamed A. Latency to first interictal epileptiform discharge in epilepsy with outpatient ambulatory EEG. Clin Neurophysiol. 2012;123:1732–5.

    Article  Google Scholar 

  9. Jayakar P, Duchowny M, Resnick TJ, Alvarez LA. Localization of seizure foci: pitfalls and caveats. J Clin Neurophysiol. 1991;8(4):414–31.

  10. Benbadis SR, Tatum WO. Overintepretation of EEGs and misdiagnosis of epilepsy. J Clin Neurophysiol. 2003;20(1):42–4.

    Article  PubMed  Google Scholar 

  11. Kuratani J, Pearl PL, Sullivan LR, et al. American clinical neurophysiology society guideline 5: minimum technical standards for pediatric electroencephalography. Neurodiagn J. 2016;56(4):266–75.

    Article  PubMed  Google Scholar 

  12. Watemberg N, Tziperman B, Dabby R, Hasan M, Zehavi L, Lerman-Sagie T. Adding video recording increases the diagnostic yield of routine electroencephalograms in children with frequent paroxysmal events. Epilepsia. 2005;46(5):716–9.

    Article  PubMed  Google Scholar 

  13. Dash D, Dash C, Primrose S, et al. Update on minimal standards for electroencephalography in Canada: a review by the Canadian Society of Clinical Neurophysiologists. Can J Neurol Sci. 2017;44(6):631–42.

    Article  PubMed  Google Scholar 

  14. Ashrafi MR, Mohammadi M, Tafarroji J, Shabanian R, Salamati P, Zamani GR. Melatonin versus chloral hydrate for recording sleep EEG. Eur J Paediatr Neurol. 2010;14(3):235–8.

    Article  PubMed  Google Scholar 

  15. Jain P, Sharma S, Sharma A, Goel S, Jose A, Aneja S. Efficacy and safety of oral triclofos as sedative for children undergoing sleep electroencephalogram: an observational study. J Pediatr Neurosci. 2016;11(2):105–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Wassmer E, Carter PFB, Quinn E, et al. Melatonin is useful for recording sleep EEGs: a prospective audit of outcome. Dev Med Child Neurol. 2001;43(11):735–8.

    Article  CAS  PubMed  Google Scholar 

  17. Nordli DR Jr. Usefulness of video-EEG monitoring. Epilepsia. 2006;47(s1):26–30.

    Article  PubMed  Google Scholar 

  18. Kim HL, Donnelly JH, Tournay AE, Book TM, Filipek P. Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center. Epilepsia. 2006;47(2):394–8.

    Article  PubMed  Google Scholar 

  19. Itoh Y, Oguni H, Hirano Y, Osawa M. Study of epileptic drop attacks in symptomatic epilepsy of early childhood – differences from those in myoclonic-astatic epilepsy. Brain Dev. 2015;37(1):49–58.

  20. Hirano Y, Oguni H, Funatsuka M, Imai K, Osawa M. Differentiation of myoclonic seizures in epileptic syndromes: a video-polygraphic study of 26 patients. Epilepsia. 2009;50(6):1525–35.

    Article  PubMed  Google Scholar 

  21. LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach: a report from the international league against epilepsy nonepileptic seizures task force. Epilepsia. 2013;54(11):2005–18.

    Article  PubMed  Google Scholar 

  22. Williams K, Jarrar R, Buchhalter J. Continuous video-EEG monitoring in pediatric intensive care units. Epilepsia. 2011;52(6):1130–6.

    Article  PubMed  Google Scholar 

  23. Shahwan A, Bailey C, Shekerdemian L, Harvey AS. The prevalence of seizures in comatose children in the pediatric intensive care unit: a prospective video-EEG study. Epilepsia. 2010;51(7):1198–204.

    Article  PubMed  Google Scholar 

  24. Gaily E, Liukkonen E, Paetau R, Rekola M, Granström M-L. Infantile spasms: diagnosis and assessment of treatment response by video-EEG. Dev Med Child Neurol. 2001;43(10):658–67.

    Article  CAS  PubMed  Google Scholar 

  25. Valente KD, Freitas A, Fiore LA, Gronich G, Negrão N. The diagnostic role of short duration outpatient V-EEG monitoring in children. Pediatr Neurol. 2003;28(4):285–91.

    Article  PubMed  Google Scholar 

  26. Goldstein J, Slomski J. Epileptic spasms: a variety of etiologies and associated syndromes. J Child Neurol. 2008;23(4):407–14.

    Article  PubMed  Google Scholar 

  27. Srikumar G, Bhatia M, Jain S, Maheshwari M. Usefulness of short term video-EEG monitoring in children with frequent intractable episodes. Neurol India. 2000;48(1):29–32.

    CAS  PubMed  Google Scholar 

  28. Montenegro MA, Sproule D, Mandel A, et al. The frequency of non-epileptic spells in children: results of video–EEG monitoring in a tertiary care center. Seizure. 2008;17(7):583–7.

    Article  PubMed  Google Scholar 

  29. Riquet A, Lamblin M-D, Bastos M, et al. Usefulness of video-EEG monitoring in children. Seizure. 2011;20(1):18–22.

    Article  PubMed  Google Scholar 

  30. Yang Z, Liu X, Qin J, et al. Clinical and electrophysiological characteristics of startle epilepsy in childhood. Clin Neurophysiol. 2010;121(5):658–64.

    Article  PubMed  Google Scholar 

  31. Tibussek D, Wohlrab G, Boltshauser E, Schmitt B. Proven startle-provoked epileptic seizures in childhood: semiologic and electrophysiologic variability. Epilepsia. 2006;47(6):1050–8.

    Article  PubMed  Google Scholar 

  32. Foley CM, Legido A, Miles DK, Grover WD. Diagnostic value of pediatric outpatient video-EEG. Pediatr Neurol. 1995;12(2):120–4.

    Article  CAS  PubMed  Google Scholar 

  33. Martin RC, Gilliam FG, Kilgore M, Faught E, Kuzniecky R. Improved health care resource utilization following video-EEG-confirmed diagnosis of nonepileptic psychogenic seizures. Seizure. 1998;7(5):385–90.

    Article  CAS  PubMed  Google Scholar 

  34. Eeg-Olofsson O, Petersén I, Selldén U. The development of the electroencephalogram in normal children from the age of 1 through 15 years. Paroxysmal activity Neuropadiatrie. 1971;2(4):375–404.

    Article  CAS  PubMed  Google Scholar 

  35. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512–21.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ohtahara S, Yamatogi Y. Ohtahara syndrome: with special reference to its developmental aspects for differentiating from early myoclonic encephalopathy. Epilepsy Res. 2006;70(Suppl 1):S58–67.

    Article  PubMed  Google Scholar 

  37. Coppola G. Malignant migrating partial seizures in infancy: an epilepsy syndrome of unknown etiology. Epilepsia. 2009;50(Suppl 5):49–51.

    Article  PubMed  Google Scholar 

  38. Caraballo RH, Ruggieri V, Gonzalez G, et al. Infantile spams without hypsarrhythmia: a study of 16 cases. Seizure. 2011;20(3):197–202.

    Article  PubMed  Google Scholar 

  39. Hrachovy RA, Frost JD. Infantile epileptic encephalopathy with hypsarrhythmia (infantile spasms/west syndrome). J Clin Neurophysiol. 2003;20(6):408–25.

    Article  PubMed  Google Scholar 

  40. Caraballo RH, Capovilla G, Vigevano F, Beccaria F, Specchio N, Fejerman N. The spectrum of benign myoclonus of early infancy: clinical and neurophysiologic features in 102 patients. Epilepsia. 2009;50(5):1176–83.

    Article  PubMed  Google Scholar 

  41. Caraballo RH, Flesler S, Pasteris MC, Lopez Avaria MF, Fortini S, Vilte C. Myoclonic epilepsy in infancy: an electroclinical study and long-term follow-up of 38 patients. Epilepsia. 2013;54(9):1605–12.

    Article  CAS  PubMed  Google Scholar 

  42. Seneviratne U, Woo JJ, Boston RC, Cook M, D’Souza W. Focal seizure symptoms in idiopathic generalized epilepsies. Neurology. 2015;85(7):589–95.

    Article  PubMed  Google Scholar 

  43. Sankhyan N. Non-epileptic paroxysmal events mimicking seizures. Indian J Pediatr. 2014;81(9):898–902.

    Article  PubMed  Google Scholar 

  44. Szabó L, Siegler Z, Zubek L, et al. A detailed semiologic analysis of childhood psychogenic nonepileptic seizures. Epilepsia. 2012;53(3):565–70.

    Article  PubMed  Google Scholar 

  45. Popkirov S, Grönheit W, Wellmer J. A systematic review of suggestive seizure induction for the diagnosis of psychogenic nonepileptic seizures. Seizure. 2015;31:124–32.

    Article  PubMed  Google Scholar 

  46. Benbadis SR, Siegrist K, Tatum WO, Heriaud L, Anthony K. Short-term outpatient EEG video with induction in the diagnosis of psychogenic seizures. Neurology. 2004;63(9):1728–30.

    Article  CAS  PubMed  Google Scholar 

  47. Chung SS, Gerber P, Kirlin KA. Ictal eye closure is a reliable indicator for psychogenic nonepileptic seizures. Neurology. 2006;66(11):1730–1.

    Article  PubMed  Google Scholar 

  48. Bergen D, Ristanovic R. Weeping as a common element of pseudoseizures. Arch Neurol. 1993;50(10):1059–60.

    Article  CAS  PubMed  Google Scholar 

  49. Peguero E, Abou-Khalil B, Fakhoury T, Mathews G. Self-injury and incontinence in psychogenic seizures. Epilepsia. 1995;36(6):586–91.

    Article  CAS  PubMed  Google Scholar 

  50. Nagyova R, Horsburgh G, Robertson A, Zuberi SM. The clinical utility of ambulatory EEG in childhood. Seizure. 2019;64:45–9.

    Article  PubMed  Google Scholar 

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LK, PJ, DN contributed equally to the manuscript preparation and editing. All three approved the final version. LK will act as the guarantor.

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Correspondence to Lakshminarayanan Kannan.

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Written informed consent was obtained from the parents/caregivers for the publication of clinical details, EEG and videos, as per the hospital guidelines.

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Kannan, L., Jain, P. & Nayak, D. Role of Video-EEG in Children. Indian J Pediatr 88, 1007–1016 (2021). https://doi.org/10.1007/s12098-020-03605-4

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