Diagnostic yield of five minutes compared to three minutes hyperventilation during electroencephalography

Crăciun, Laura; Varga, Edina; Mı̂ndruță, Ioana; Meritam, Pirgit; Horváth, Zoltán; Terney, Daniella; Gardella, Elena; Alving, Jørgen; Vécsei, László; Beniczky, Sándor

doi:10.1016/j.seizure.2015.06.003

Cited by 29 publications

(45 citation statements)

References 10 publications

(20 reference statements)

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“…We found five studies that quantified the success of voluntary hyperventilation for induction of PNES events (Table 4). Craciun et al aimed to test whether 5 min of hyperventilation increased the diagnostic yield of EEG for clinical events compared to 3 min of hyperventilation [31]. They found that ten out of 22 PNES patients (45.5%) had an event during the 5-min hyperventilation, while [33].…”

Section: Hyperventilation For Induction Of Pnesmentioning

confidence: 99%

The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis

Indranada

Mullen

Duncan

et al. 2018

Seizure

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Previous studies have reported moderate rates of association of panic in PNES, though the proportions varied considerably across the literature, with physical symptoms more commonly reported than affective. Hyperventilation is an effective inducer of PNES events in a minority, and can be observed occurring in a minority of patients without induction. These results support an important, albeit not essential, role for panic and hyperventilation in the pathogenesis of PNES events.

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Section: Hyperventilation For Induction Of Pnesmentioning

confidence: 99%

The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis

Indranada

Mullen

Duncan

et al. 2018

Seizure

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“…They found that patients benefitted from prolonging HV from 3 to 5 minutes: 16% experienced seizures, and in 30% interictal epileptiform discharges were triggered by the extra 2 minutes of HV. 11 In our study, HV while sitting triggered absence seizures in 17 patients (85%). Four of these children did not experience a seizure during supine HV, rendering sitting HV essential for diagnosis (p = 0.031) in these four children.…”

Section: Discussionmentioning

confidence: 46%

Absence seizure provocation during routine EEG: Does position of the child during hyperventilation affect the diagnostic yield?

Rozenblat

Kraus

Mahajnah³

et al. 2020

Seizure

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When performed correctly, hyperventilation (HV) for three minutes provokes absence seizures in virtually all children, a finding suggestive of a diagnosis of childhood absence epilepsy (CAE). Interestingly, some children experience absence seizures while performing HV in the office yet do not experience absences during HV on subsequent routine EEG. In most instances, HV during routine EEG is performed in the supine position, while in the office HV is done with the child sitting-up. Therefore, we hypothesized that the position in which HV is performed may influence its yield in provoking absence seizures. Methods: We conducted a randomized multi-center controlled trial among children (4-10 years old) with suspected CAE. During a routine EEG, children were asked to perform HV twice, in the supine and sitting positions. Results: Twenty children (four males) diagnosed with CAE were included in the analysis. Seventeen of the 20 patients experienced absence seizures while sitting and 13 experienced seizures during supine HV (p = 0.031). All patients that had absence seizures during supine HV also had seizures during sitting HV. Among patients with absences in both positions, seizure duration was significantly shorter during sitting HV (mean 8.69 seconds) than during supine HV (mean 12 seconds) (p = 0.042).An opposite tendency was seen in the younger age group (4-7 years), with shorter seizures in the supine HV group (5.6 seconds supine, 7.57 seconds sitting, p = 0.019). Conclusions: HV in the sitting position may increase the yield of provoking absence seizures during routine EEGs, thereby improving its sensitivity in the diagnosis of CAE.

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“…If no significant EEG changes, outside of normal buildup, are noted during the routine three minutes of HV, and there is a strong suspicion of absence epilepsy, the protocol should be prolonged and/or repeated according to laboratory standards 9 22 , 31 If there is unexpected abnormal hypersynchronization activity during HV, the possibility of hypoglycaemia or other metabolic abnormalities or simply that the patient may not have stopped hyperventilating should be excluded 30 . The technologist should always write down an assessment of the quality of patient effort periodically throughout this procedure as well as in the technologist report 22…”

Section: Eeg Yieldmentioning

confidence: 99%

Update on Minimal Standards for Electroencephalography in Canada: A Review by the Canadian Society of Clinical Neurophysiologists

Dash

Primrose

et al. 2017

Can. J. Neurol. Sci.

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Surface electroencephalogram (EEG) recording remains the gold standard for noninvasive assessment of electrical brain activity. It is the most efficient way to diagnose and classify epilepsy syndromes as well as define the localization of the epileptogenic zone. The EEG is useful for management decisions and for establishing prognosis in some types of epilepsy. Electroencephalography is an evolving field in which new methods are being introduced. The Canadian Society of Clinical Neurophysiologists convened an expert panel to develop new national minimal guidelines. A comprehensive evidence review was conducted. This document is organized into 10 sections, including indications, recommendations for trained personnel, EEG yield, paediatric and neonatal EEGs, laboratory minimal standards, requisitions, reports, storage, safety measures, and quality assurance.

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Diagnostic yield of five minutes compared to three minutes hyperventilation during electroencephalography

Cited by 29 publications

References 10 publications

The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis

The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis

Absence seizure provocation during routine EEG: Does position of the child during hyperventilation affect the diagnostic yield?

Update on Minimal Standards for Electroencephalography in Canada: A Review by the Canadian Society of Clinical Neurophysiologists

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