A study of prevalence of abnormal EEG and its association between various clinical presentations of atypical febrile seizures

Authors

  • Bruntha Priyavathani J. Department of Paediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Sriram Pothapregada Department of Paediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Anuradha Varadhan Department of Paediatrics, Rajiv Gandhi Government Women and Children Hospital, Puducherry, India
  • Suresh C. Thirunavukarasu Department of Neurology, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20205517

Keywords:

Atypical febrile seizures, Febrile seizures, Prevalence, Quantitative EEG

Abstract

Background: Quantitative EEG is a rapidly emerging tool in the diagnosis and follow up of various neurological disorders and can act as predictive marker for subsequent epilepsy in children with complex febrile seizure. The present study aimed to estimate the prevalence of abnormal electroencephalogram (EEG) and to find the association between Quantitative EEG (qEEG) and various clinical features of atypical febrile seizures(AFS).

Methods: EEG was recorded along with clinical features including the age at onset, duration of episode, number of episodes in a day, type of seizure and the recurrences from the children aged between 6-60 months with atypical febrile seizures. EEG recordings were classified into Normal and abnormal EEG with epileptiform changes by the expert interpretation and the distribution of above said clinical features in the both groups were analyzed. It is also attempted to find the association between qEEG and few of the clinical features.

Results: Prevalence of abnormal EEG in atypical febrile seizures was 33.9%. There were no significant differences in the distribution of abnormal EEG and their association with various clinical features of AFS. Significantly increased absolute power of θ and α waves were recorded from the frontal montages in the children with epileptiform changes in the EEG.

Conclusions: qEEG changes can be also considered as marker of severity of febrile seizure episodes. Many prospective studies with long-term follow up are required to establish the predictability of future epilepsy by qEEG.

Author Biographies

Bruntha Priyavathani J., Department of Paediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India

Senior Resident 

Department of Paediatrics

Sriram Pothapregada, Department of Paediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India

Professor and Head of the Department
Department of Pediatrics

Anuradha Varadhan, Department of Paediatrics, Rajiv Gandhi Government Women and Children Hospital, Puducherry, India

Consultant

Department of Pediatrics

Suresh C. Thirunavukarasu, Department of Neurology, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, India

Head of the Department

Department of Neurology

References

Naik S, Jan M, Rafiq W, Ahmad S, Maqbool M. Febrile convulsions in preschool children Kashmir India. Int J Contemp Pediatr. 2015;9:213-5.

Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord. 2015;17(2):117-23.

Amudhan S, Gururaj G, Satishchandra P. Epilepsy in India I: Epidemiology and Pub Health. Ann Indian Acad Neurol. 2015;18(3):263-77.

Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia. 1994;35(2):S1-6.

Lüders H, Acharya J, Baumgartner C, Benbadis S, Bleasel A, Burgess R. Semiological Seizure Classification*. Epilepsia. 1998;39(9):1006-13.

Annegers JF, Hauser WA, Elveback LR, Kurland LT. The risk of epilepsy following febrile convulsions. Neurology. 1979;29(3):297-303.

Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors Prognostic of Unprovoked Seizures after Febrile Convulsions. N Engl J Med. 1987;316(9):493-8.

Hwang G, Kang HS, Park SY, Han KH, Kim SH. Predictors of unprovoked seizure after febrile seizure: Short-term outcomes. Brain Dev. 2015;37(3):315-21.

Lee SH, Byeon JH, Kim GH, Eun B-L, Eun S-H. Epilepsy in children with a history of febrile seizures. Korean J Pediatr. 2016;59(2):74-9.

Gloss D, Varma JK, Pringsheim T, Nuwer MR. Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurol. 2016;87(22):2375-9.

Begić D, Knapić V, Grubišin J, Rajačić B, Filipčić I, Telarović I, et al. Quantitative electroencephalography in schizophrenia and depression. Psychiatr Danub. 2011;23(4):355-62.

Koyama A, Matsui T, Sugisawa T. Febrile convulsions in northern Japan: a quantitative and qualitative analysis of EEG and clinical findings. Acta Neurol Scand. 1991;83(6):411-7.

Kuang YQ, Kong B, Yang T, Cheng L, Gu J, Zhou H-T. Epileptiform discharges and frontal paroxysmal EEG abnormality act as predictive marker for subsequent epilepsy in children with complex febrile seizures. Clin EEG Neurosci. 2014;45(4):299-303.

Pediatrics AA. Febrile seizures: long-term management of children with fever-associated seizures. Pediatrics. 1980;66(6):1009-12.

Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I--Prevalence and recurrence in the first five years of life. Br Med J Clin Res. 1985;290(6478):1307-10.

Fallah R, Alaei A, Karbasi S, Shajari A. Chloral hydrate, chloral hydrate--promethazine and chloral hydrate -hydroxyzine efficacy in electroencephalography sedation. Indian J Pediatr. 2014;81(6):541-6.

Frantzen E, Buchthal ML, Nygaard A. Longitudinal EEG and clinical study of children with febrile convulsions. Electroen- Cephalogr Clin Neurophysiol. 1968;24:197-212.

Maytal J, Steele R, Eviatar L, Novak G. The value of early postictal eeg in children with complex febrile seizures. Epilepsia. 2000;41(2):219-21.

Joshi C, Wawrykow T, Patrick J, Prasad A. Do clinical variables predict an abnormal EEG in patients with complex febrile seizures? Seizure Eur J Epilepsy. 2005;14(6):429-34.

Kuturec M, Emoto SE, Sofijanov N, Dukovski M, Duma F, Ellenberg JH, et al. Febrile seizures: is the EEG a useful predictor of recurrences? Clin Pediatr. 1997;36(1):31-6.

Sofijanov N, Emoto S, Kuturec M, Dukovski M, Duma F, Ellenberg JH, et al. Febrile seizures: clinical characteristics and initial EEG. Epilepsia. 1992;33(1):52-7.

Tsuboi T. Correlation between EEG abnormality and age in childhood. Neuropädiatrie. 1978;9(3):229-38.

Tsuboi T, Endo S. Febrile convulsions followed by nonfebrile convulsions. a clinical, electroencephalographic and follow-up study. Neuropädiatrie. 1977;8(3):209-23.

Petersén I, Olofsson O. The development of the electroencephalogram in normal children from the age of 1 through 15 years non-paroxysmal activity. Neuropädiatrie. 1971;2(03):247-304.

Chevrie JJ, Aicardi J. Duration and lateralization of febrile convulsions etiological factors. Epilepsia. 1975;16(5):781-9.

Chung S. Febrile seizures. Korean J Pediatr. 2014;57(9):384-95.

Kim H, Byun SH, Kim JS, Lim BC, Chae JH, Choi J. Clinical and EEG risk factors for subsequent epilepsy in patients with complex febrile seizures. Epilepsy Res. 2013;105(1):158-63.

Wo SB, Lee JH, Lee YJ, Sung TJ, Lee KH, Kim SK. Risk for developing epilepsy and epileptiform discharges on EEG in patients with febrile seizures. Brain Dev. 2013;35(4):307-11.

Downloads

Published

2020-12-23

Issue

Section

Original Research Articles