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Jornal de Pediatria
On-line version ISSN 1678-4782
FREITAS, Alessandra; FIORE, Lia A.; GRONICH, Gary and VALENTE, Kette D.. The diagnostic value of short-term video-EEG monitoring in childhood. J. Pediatr. (Rio J.) [online]. 2003, vol.79, n.3, pp.259-264. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572003000300013.
OBJECTIVE: the objective of this study was to investigate the value of short-term video-EEG monitoring in a pediatric population with distinct clinical complaints in order to verify the benefits and limitations of this procedure. PATIENTS AND METHODS: a prospective protocol, developed in the University of São Paulo, analyzed 38 consecutive patients (age ranging from 4 months to 17 years; mean 6.9 years). All patients were referred in order to establish the diagnosis. The patients were divided in the following groups according to the main clinical complaint: doubts about seizure/syndromic classification (Group I, n = 22); differential diagnosis with non-epileptic events (Group II, n = 8) and differential diagnosis between cognitive decline and status epilepticus (Group III, n = 8). RESULTS: clinical episodes were observed in 36 patients (94.7%). In group I, seizures were reclassified in 11/22 (50%) patients and confirmed in eight (36.4%). One patient presented a sleep disorder and two did not present clinical events during monitoring. Syndromic classification was modified in nine (40.9%). In group II, four patients (50%) presented epileptic seizures; two had movement disorders and two, non-epileptic events. The cognitive deterioration was correlated with non-convulsive status epilepticus in five children (62.5%) of group III. Alterations of therapeutic and/or diagnostic approaches, as a consequence of monitoring, were performed in 21/38 (55.3%) patients. CONCLUSION: in our series, short-term video-EEG monitoring established a reliable diagnosis in most patients due to correlation between clinical and EEG data. This procedure was well tolerated by children, including infants and those with psychiatric disorders.
Keywords : epilepsy; monitoring; classification.