Abstract
Objective: To investigate the occurrence of seizures based on sleep/wake status and electrographic localization in pediatric epilepsy. Background We previously described diurnal and sleep/wake patterns of seizures based on clinical presentation and electrographic localization. In this study, we investigated in a larger patient series whether the sleep/wake state of seizure onset can predict EEG localization of seizures with different semiology. Design/Methods: Charts of 955 consecutive patients with epilepsy undergoing continuous video-EEG monitoring were reviewed for EEG localization, seizure occurrence out of wakefulness or sleep and for clinical seizure type. Seizures were characterized according to 2001 ILAE terminology. Proportions were compared using binomial methods. Odds ratios were used to compare seizure localization based sleep/wake state. Results: 407 patients aged 0-21 (194 girls, mean age 9.2 ± 6.0 years) had 1,754 seizures. The majority of seizures occurred out of wakefulness (58%, p Conclusions: Sleep/wake states at seizure onset can predict EEG localization of seizures with certain semiology. Clonic, dyscognitive and myoclonic seizures have more likely a generalized EEG onset when occurring during wakefulness, and a focal EEG onset when occurring out of sleep. Disclosure: Dr. Ramgopal has nothing to disclose. Dr. Loddenkemper has received personal compensation for activities with Eisai Inc. as a consultant. Dr. Loddenkemper has received research support from NIH/NINDS, The Epilepsy Foundation of America, CIMIT/DOD, Harvard Medical School Office of Faculty Development, and the Children9s Hospital Program for Patient Safety and Quality Improvement. Dr. Vendrame has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Zarowski has nothing to disclose. Dr. Alexopoulos has received personal compensation for activities with UCB Pharma as a speaker. Dr. Wyllie has nothing to disclose. Dr. Kothare has nothing to disclose.
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