Description of Patterns in Reduced-Lead Electroencephalography Performed for Suspected Electrographic Seizures in Pediatric Patients With Altered Mental Status Using Standardized Terminology

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-05-13 DOI:10.1016/j.pediatrneurol.2025.05.011

Hiroshi Yamaguchi MD, PhD, DVM , Azusa Maruyama MD , Masahiro Nishiyama MD, PhD , Takuya Ueda MD , Hiroto Hongo MD , Shizuka Oikawa MD, PhD , Shoichi Tokumoto MD, PhD , Kazumi Tomioka MD, PhD , Satoshi Matsui MD, PhD , Takuro Hayashi MD , Ryojiro Tanaka MD, PhD , Kandai Nozu MD, PhD , Hiroaki Nagase MD, PhD

{"title":"Description of Patterns in Reduced-Lead Electroencephalography Performed for Suspected Electrographic Seizures in Pediatric Patients With Altered Mental Status Using Standardized Terminology","authors":"Hiroshi Yamaguchi MD, PhD, DVM , Azusa Maruyama MD , Masahiro Nishiyama MD, PhD , Takuya Ueda MD , Hiroto Hongo MD , Shizuka Oikawa MD, PhD , Shoichi Tokumoto MD, PhD , Kazumi Tomioka MD, PhD , Satoshi Matsui MD, PhD , Takuro Hayashi MD , Ryojiro Tanaka MD, PhD , Kandai Nozu MD, PhD , Hiroaki Nagase MD, PhD","doi":"10.1016/j.pediatrneurol.2025.05.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to analyze and describe reduced-lead electroencephalographic (EEG) data for suspected electrographic seizure (ESz) in pediatric patients presenting with altered mental status (AMS) in the emergency department (ED) according to standardized EEG terminology. The secondary aim was to compare the characteristics of these EEG patterns across febrile seizure (FS), acute encephalopathy/encephalitis (AE/AES), and epilepsy.</div></div><div><h3>Methods</h3><div>Epileptologists retrospectively analyzed the medical records and findings of reduced-lead EEG performed for suspected ESz in pediatric patients with AMS in ED between March 1, 2019, and February 28, 2023. Fifty-one EEG results with few artifacts were extracted; these patterns were described according to the American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology 2021. The obtained clinical diagnoses were categorized into three groups: FS, AE/AES, and epilepsy, and the characteristics of EEG patterns were compared.</div></div><div><h3>Results</h3><div>Clinical seizure types were not significantly different between FS, AE/AES, and epilepsy. In terms of EEG, there was no difference in Main term 1 (localization) among the groups. With regard to Main term 2 (morphology), patients with FS and AE/AES had commonly rhythmic delta activity, whereas patients with epilepsy had significantly more spikes and waves. ESz was observed in 25 patients; their incidence was significantly higher in the epilepsy group.</div></div><div><h3>Conclusions</h3><div>This is the first study to describe patterns in reduced-lead EEG performed for suspected ESz in pediatric patients with AMS due to disorders commonly encountered in the ED by using standardized EEG terminology and to compare EEG patterns among these disorders.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"169 ","pages":"Pages 21-30"},"PeriodicalIF":2.1000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric neurology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0887899425001237","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

This study aimed to analyze and describe reduced-lead electroencephalographic (EEG) data for suspected electrographic seizure (ESz) in pediatric patients presenting with altered mental status (AMS) in the emergency department (ED) according to standardized EEG terminology. The secondary aim was to compare the characteristics of these EEG patterns across febrile seizure (FS), acute encephalopathy/encephalitis (AE/AES), and epilepsy.

Methods

Epileptologists retrospectively analyzed the medical records and findings of reduced-lead EEG performed for suspected ESz in pediatric patients with AMS in ED between March 1, 2019, and February 28, 2023. Fifty-one EEG results with few artifacts were extracted; these patterns were described according to the American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology 2021. The obtained clinical diagnoses were categorized into three groups: FS, AE/AES, and epilepsy, and the characteristics of EEG patterns were compared.

Results

Clinical seizure types were not significantly different between FS, AE/AES, and epilepsy. In terms of EEG, there was no difference in Main term 1 (localization) among the groups. With regard to Main term 2 (morphology), patients with FS and AE/AES had commonly rhythmic delta activity, whereas patients with epilepsy had significantly more spikes and waves. ESz was observed in 25 patients; their incidence was significantly higher in the epilepsy group.

Conclusions

This is the first study to describe patterns in reduced-lead EEG performed for suspected ESz in pediatric patients with AMS due to disorders commonly encountered in the ED by using standardized EEG terminology and to compare EEG patterns among these disorders.

查看原文本刊更多论文

使用标准化术语描述精神状态改变的儿童患者疑似电图癫痫的低铅脑电图模式

本研究旨在分析和描述在急诊科（ED）表现为精神状态改变（AMS）的儿童患者疑似电性癫痫发作（ESz）的低铅脑电图（EEG）数据。次要目的是比较热性癫痫发作（FS）、急性脑病/脑炎（AE/AES）和癫痫的脑电图特征。方法回顾性分析2019年3月1日至2023年2月28日在急诊科就诊的AMS患儿疑似ESz的病历和低导联脑电图结果。提取51个伪影较少的EEG结果；这些模式是根据美国临床神经生理学学会的2021年标准化重症监护EEG术语描述的。将获得的临床诊断分为FS组、AE/AES组和癫痫组，并比较脑电图特征。结果FS、AE/AES与癫痫的临床发作类型无显著差异。在脑电方面，各组间主要项1（定位）无差异。在主项2（形态学）方面，FS和AE/AES患者通常有节律性δ波活动，而癫痫患者有明显更多的峰和波。25例患者观察到ESz；癫痫组的发病率明显更高。本研究首次使用标准化的脑电图术语描述了因急诊科常见疾病导致的AMS患儿疑似ESz的低导联脑电图模式，并比较了这些疾病的脑电图模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.