Focal electroencephalographic abnormalities and computerised tomography findings in children with seizures.

Abstract

A persistent focal abnormality was observed in 157 (16%) electroencephalograms undertaken in 964 consecutive children with epileptic and non-epileptic seizures seen over one year. CT head scans were performed in 121 (77%) of the 157 children with a focus on the EEG; 26 (21%) showed an abnormality, and 21 (81%) of the abnormalities were localised. There was no difference in the proportion of abnormal scans associated with a delta or slow wave focus compared with a spike or sharp wave focus. An abnormal scan was uncommon after a single seizure. In only two patients (1.7% of all scans) did the findings on CT alter or greatly influence subsequent management. ( Neurol Neurosurg Psychiatry 1993;56:369-37 Scans were performed with a third generation Siemens Somatrom 2 scanner before and after intravenous contrast and with specific views of the temporal lobes. Records showing symmetric, posterior slow waves of youth, bilateral multifocal abnormalities, and asymmetry of background rhythmic activity (without any focal abnormality) were excluded from the study. Reactiveness of the focal slow wave abnormality was not assessed.Statistical analysis of the CT and EEG appearances used the X2 test. Repeat or follow up EEGs were undertaken in about a quarter of subjects but these data have not been analysed in this report. ResultsEEGs were recorded in 964 consecutive patients, aged 2 months to 17 years (mean 8 years). A total of 182 patients had had a single witnessed seizure; the remaining 782 patients had had at least two seizures. It was difficult to ascertain what proportion of these 782 patients had epilepsy as they were not all under the care of the authors and clinical information was therefore limited. However, at least 530 were considered to have epilepsy.The records showed a continuous, persistent, or recurring focal abnormality in 157 patients (16%), of which 83 were slow waves and 74 were spike or sharp wave foci. Three of the 157 patients showed both a slow wave and epileptiform focus. CT head scans were performed in 121 of the 157 patients (77%) with an EEG focus. CT was not recommend-369 on 12 May 2018 by guest. Protected by copyright.

Computerized Axial Tomography Findings in Children with Afebrile Seizures: A Hospital Based Study at Eastern Nepal

“…13,14 Similar to our finding, in study by Gibbs et al, atrophy was the most common CT scan abnormality that was found in 9.0% of children suffering from seizure. 8 CT revealed generalized atrophy in 6.0% and focal atrophy in 7.0% children in study by Bachman et al 4 NCC was the second most common abnormality detected by CT scan in our study.…”

“…4,[8][9][10] In studies done in children, the positivity rate of CT scan were variable, ranging from 21.0% to 41.7% in developed countries and as high as 70.0% in Indian subcontinent. The positivity rate of CT scan was 21.0% out of investigated cases in study by Gibbs et al, 8 41.7% in study by Ladurner et al, 11 30.0 % in study by Bachman et al, 4 and 39.5 % in study by Al-Sulaiman et al 12 This wide variation in positivity rate of CT scan might be because of bias in selection of cases for ordering CT scan. Another reason could be high prevalence of neurocysticercosis (NCC) and perinatal brain injury in developing world, especially Indian subcontinent.…”

An audit of paediatric epilepsy care

“…10 The yield of abnormalities is highest in children with partial seizures who have focal abnormalities on EEG and/or neurological examination, and in neonates irrespective of seizure type, neurological examination, or EEG findings 911 12 One child in this survey presented at the age of 8 years with focal seizures and had a cystic area on computed tomography (CT) at presentation. Repeat CT six years later because of intractable partial seizures and unilateral clumsiness led to excision of this cystic lesion, which was found to be a gangliocytoma.…”

Clinico - diagnostic and therapeutic relevance of computed tomography scan of brain in children with partial seizures

“…[3] Only a few studies have addressed the radiological evaluation of children with partial seizures [Table 5]. There is higher incidence of normal CT scan of brain (50-79%) in studies from the developed countries[81018] when compared to studies from India (37-76%). [11920] Lagenstein et al .…”