USEFULNESS OF SLEEP-DEPRIVED EEG IN THE DIAGNOSIS OF SEIZURE DISORDERS IN CHILDREN

Objectives: The study aimed to test routine use of sleep deprivation (SD) in electroencephalography in pediatric patients, with, or suspect of, seizures, especially with first unprovoked seizure (FUS).

Materials & Methods: Between September 2000 and November 2002, 598 children and adolescents were randomly assigned to a 10-minute surface EEG, routinely, or after partial or total SD. In those who refused or could not tolerate the SD, a routine EEG was done.

Results: Of 598 patients, 544 (91%) had seizures; 54 (9%), were seizure suspects, or had seizure “mimickers”(syncope, night terrors, pseudo-seizures, etc). Of seizure patients,210 (38.6%) had FUS, 334 (61.4%), had > one seizures at EEG performance.

Epileptifom EEG's were more in seizure patients sleep -deprived before performing EEG, compared to routine group. Conversely, more normal EEG's were seen in routine EEG's (p. value <00001, x2=76.5).

Similarly, more abnormal sleep-deprived EEG's were seen in patients with FUS than routine EEG's. Patients with complex partial seizure had especially more abnormal EEG's with SD (P<00001).

Older patients could tolerate SD better than the youngsters; so more routine EEG;s had to be performed in the younger patients. Younger children only tolerated partial SD. No difference was found in patients with absence epilepsy between two groups. In 5 patients with juvenile myoclonic epilepsy, SD precipitated a generalized tonic-clonic seizure necessitating anti-epileptic drug administration to terminate the seizure.

All patients with non-seizure episodes had normal EEGs.

Conclusion: (SD) is useful in selected pediatric patients with seizure disorder, especially FUS, when abnormal EEG might dictate anti-epileptic therapy.

SD is not necessary in some, and is intolerable in others. In suspicious episodes, it helps rule out seizure disorder.

Keywords: Seizure, (EEG), Sleep Deprivation (SD), Children