Diagnostic value of interictal eeg and short-duration video eeg monitoring with sleep deprivation for newly diagnosed epileptic children

Objective: : It is aimed to compare diagnostic value of interictal EEG and short-duration video EEG monitoring with sleep deprivation for children with idiopathic/cryptogenic epilepsy diagnosis according to medical history and clinical findings.Method: In this prospective study conducted on patients admitted to Pediatric Neurology Clinic of the Department of Pediatrics between 01.06.2010 and 30.06.2012; patients between ages of 6-17 years, diagnosed with idiopathic/cryptogenic focal and generalized epilepsy according to history and clinical findings, not yet started to antiepileptic drugs and normal interictal EEGs were investigated. Demographic information, medical and family history, presence of febril and neonatal seizure, clinical seizure and epilepsy type, frequency, number of seizure, precipitating factors for seizure, time of the seizures during the day (sleep, wake, mixed) and time of interictal EEGs (sleep/wake) were recorded for all participating patients. Short-duration VEM (3-4 hours) with sleep deprivation was applied to all patients.Findings: Results of short-duration (3-4 hours) VEMs with partial sleep deprivation yielded that there was no epileptiform abnormalities existed for 21 patients (%42) while epileptiform abnormalities were detected for 29 patients (%58). Among 29 patients with epileptiform abnormalities according to VEM, 14 patients (%48,27) had focal and 6 patients (%20,68) had generalized abnormality while 9 patients (%31,03) had both focal and generalized abnormalities. While the epileptic discharges occur only during sleep for 12 patients (41,4%), it occurs during both sleep and wake periods (mixed) for 17 patients (%58,6). ( VEM was normal for 1 of 5 patients with temporal lobe epilepsy (20%) and it was abnormal for 4 patients (80%). VEM findings were normal in patients with frontal lobe epilepsy. While VEM findings were normal for 6 of 11 patients (54.5%) with occipital lobe epilepsy, findings were abnormal for 5 patients (45.5%)). VEM was abnormal for the only patient with diagnosis of juvenile absence epilepsy and were abnormal for 2 patients with autosomal dominant frontal lobe epilepsy. In patients with benign rolandic epilepsy, VEM findings were normal for 2 of the 5 patients, findings were abnormal for 3 patients (60%). VEM was abnormal in 1 of the 2 patients with a diagnosis of childhood epilepsy with occipital paroxysms (%50).Results: Partial sleep deprivation is effective for inducing sleep in childhood period. Short-duration VEM with sleep deprivation is an easy and cost effective method for diagnosis and classification of epilepsy. It can be readily prefered when interictal EEG is insufficient for children. Although significant differences could not be detected in our cases, it may be important for diagnosis, especially in certain types of seizures and in some epileptic syndromes. By increasing the number of patients, these findings may be more meaningful.Keywords: Epilepsy, Video EEG monitoring, Sleep deprivation