Non-epileptic paroxysmal events in early childhood and role of EEG: A single center experience

Yıl 2018, Cilt: 3 Sayı: 2, 75 - 78, 20.07.2018

Serkan Kırık Mehmet Yaşar Özkars

https://doi.org/10.25000/acem.416320

Öz

Aim: Non-epileptic paroxysmal
events are the most frequently movement disorders mimicking epilepsy. Our aim
in this article is to increase awareness among physicians by sharing our clinical
experience; to reduce unnecessary anti-epileptic use and the number of
examinations.

Methods: In total73 patients were
included in the study. Patients were evaluated according to detailed anamnesis,
video recordings, laboratory findings and electroencephalography (EEG)
findings.

Results: The most common
diagnosis in patients involved in the study was breath holding spells. The
youngest age group was benign sleeping myoclonus. None of the patients had
epileptiform activity in the EEG.

Conclusion: Non-epileptic
paroxysmal events commonly involve the unnecessary use of anti-epileptic
medications due to mimicking of epilepsy. This study has shown that detailed
anamnesis, EEG findings, and increasing use of mobile phone video reduce
unnecessary treatment and examination in these patients.

Anahtar Kelimeler

paroxysmal, electroencephalography, children

Erken çocukluk çağında epileptik olmayan paroksismal olaylar ve EEG’nin rolü: Tek merkez deneyimi

Öz

Amaç:
Epileptik olmayan paroksismal olaylar, epilepsi ile en sık karıştırılan hareket
bozukluklarıdır. Bu yazıdaki amacımız klinik deneyimimizi paylaşarak hekimler
arasında farkındalığı arttırmak; gereksiz anti-epilepik kullanımını ve tetkik
sayısını azaltmaktır.

Yöntemler:
Çalışmaya 73 hasta dahil edildi. Hastalar ayrıntılı anamnez, video kayıtları,
laboratuvar bulguları ve elektroensefalografi (EEG) bulgularına göre tanı
açısından değerlendirildi.

Bulgular:
Çalışmaya dahil edilen hastalarda en sıktanı katılma nöbetiydi. En küçük yaş grubu
benign uyku myoklonisiydi.Hastaların hiçbirinin EEG’sinde epileptiform aktivite
saptanmadı.

Sonuç:
Epileptik olmayan paroksismal olaylar, epilepsi ile sık karıştıklarından
sıklıkla gereksiz anti-epileptik tedavi kullanımı söz konusu olmaktadır. Bu
çalışma, ayrıntılı anamnez, EEG bulguları ve giderek yaygınlaşan video
kullanımının böylesi hastalarda gereksiz tedavi ve tetkik gereksinimini
azalttığını göstermiştir.

Anahtar Kelimeler

paroksismal, elektroensefalografi, çocuk

Kaynakça

• 16. Facini C, Spagnoli C, Pisani F. Epileptic and non-epileptic paroxysmal motor phenomena in newborns. J Matern Fetal Neonatal Med. 2016;26:1-8.
• 15. Nechay A, Ross LM, Stephenson JB, O’Regan M. Gratification disorder (“infantile masturbation”): a review. Arch Dis Child. 2004;89:225-6.
• 14. Wolf DS, Singer HS. Pediatric movement disorders: an update. Curr Opin Neurol. 2008;21:491-6.
• 13. Marcelli V, Russo A, Cristiano E, Tessitore A. Benign paroxysmal vertigo of childhood: A 10-year observational follow-up. Cephalalgia. 2015;35:538-44.
• 12. Mason TB 2nd, Pack AI. Sleep terrors in childhood. J Pediatr. 2005;147:388-92.
• 11. Zehetner AA, Orr N, Buckmaster A, Williams K, Wheeler DM. Iron supplementation for breath-holding attacks in children. Cochrane Database Syst Rev. 2010;5:1578–605.
• 10. Abbaskhanian A, Ehteshami S, Sajjadi S, Rezai MS. Effects of Piracetam on Pediatric Breath Holding Spells: A Randomized Double Blind Controlled Trial. Iran J Child Neurol. 2012;6:9-15.
• 9. Tomoum H, Habeeb N, Elagouza I, Mobarez H. Paediatric breath-holding spells are associated with autonomic dysfunction and iron deficiency may play a role. Acta Paediatr. 2018;107:653-57.
• 8. Patel H, Scott E, Dunn D, Garg B. Nonepileptic seizures in children. Epilepsia. 2007;48:2086–92.
• 7. Kotagal P, Costa M, Wyllie E, Wolgamuth B. Paroxysmal nonepileptic events in children and adolescents. Pediatrics. 2002;110:e46.
• 6. Peter R. Dallman. B, Iron deficiency anemia: A Synthesis of current scientific knowledge and U.S. recommendations for prevention and treatment. In: Earl R, Woteki CE, editors. Iron Deficiency Anemia: Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age. Washington (DC): National Academies Press (US);1993. pp. 57-9.
• 5. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629-808.
• 4. Tatlı B, Güler S. Non-epileptic paroxysmal events in childhood. Turk Pediatri Ars. 2017;52:59-65.
• 3. Sankhyan N. Non-epileptic paroxysmal events mimicking seizures. Indian J Pediatr. 2014;81:898-902.
• 2. Paolicchi JM. The spectrum of nonepileptic events in children. Epilepsia. 2002;43:60-4.
• 1. Cuvellier JC, Lepine A. Childhood periodic syndromes. Pediatr Neurol. 2010;42:1-11.