Long-term ambulatory EEG in pediatrics. Possibilities and limitations

Abstract

36 children aged 7 +/- 4 years with suspected seizure disorders had insufficient routine EEGs. After 54 long term EEG registrations the diagnosis and therapy had to be changed in 12 children, in 7 of them the frequency of epileptiform attacks therefore decreased. In 3 children with marked attention deficit in history during daytime and nighttime bedwetting the long term EEG showed mainly very short 3/sec spike and wave discharges (duration 0.5-2 sec). It is discussed that these bursts are EEG equivalents of attention deficit and bedwetting respectively, which disappeared by anticonvulsive treatment. Because the application of this method is very tedious we recommend the use of long term EEG recordings in children only under the following circumstances: 1. suspected attacks of seizures or episodic disturbances of behaviour and/or attention and/or enuresis at least twice a week; 2. lack of three conclusive routine EEG recordings despite of provocation procedures with full cooperation of the patient; 3. follow-up when initially abnormal. Our results are in favour of the more frequent use of a long term EEG in children having the above mentioned episodic disturbances.