Gustafsson Greta, Broström Anders, Svanborg Eva, Vrethem Magnus, Ulander Martin
Department of Clinical Neurophysiology, Linköping University Hospital, Region Östergotland, SE-581 85 Linköping, Sweden.
Division on Neurobiology, Dept of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University SE-581 83 Linköping, Sweden.
Clin Neurophysiol Pract. 2025 Jun 8;10:181-187. doi: 10.1016/j.cnp.2025.05.002. eCollection 2025.
Previous research has indicated a low diagnostic yield of initial EEGs in epilepsy diagnosis in children. This study aimed at exploring factors affecting the diagnostic yield of a first EEG in different ages, and factors affecting the choice of EEG method.
1097 EEGs performed as first recordings in children with suspected epilepsy were retrospectively analysed and divided into age groups: ≤ 5, 6-11 and 12-17 years. EEGs were classified as wake recordings with or without provocations, and sleep recordings: spontaneous sleep, sleep induced by deprivation or by melatonin premedication.
Epileptiform activity was found in 18 % of all patients, most common (30 %) in children 6-11 years old. It was more likely to be detected in melatonin-induced sleep EEGs compared to other types of sleep EEG. Presence of epileptiform discharges were positively associated to age, sleep, neurological and/or intellectual comorbidity in all children.
The prevalence of epileptiform activity varies depending on the child́s age. Sleep EEG is advantageous as first recording, especially in very young children or with neurological comorbidity.
Melatonin-induced sleep EEG has higher diagnostic yield compared to other types of sleep EEG. Age, seizure semiology and comorbidity affect the choice of EEG method.
先前的研究表明，初次脑电图（EEG）在儿童癫痫诊断中的诊断阳性率较低。本研究旨在探讨影响不同年龄段首次EEG诊断阳性率的因素，以及影响EEG方法选择的因素。
对1097例疑似癫痫儿童的首次EEG记录进行回顾性分析，并分为年龄组：≤5岁、6 - 11岁和12 - 17岁。EEG分为有或无激发试验的清醒记录以及睡眠记录：自然睡眠、剥夺睡眠或褪黑素预处理诱导的睡眠。
在所有患者中，18%发现癫痫样活动，在6 - 11岁儿童中最常见（30%）。与其他类型的睡眠EEG相比，在褪黑素诱导的睡眠EEG中更易检测到。在所有儿童中，癫痫样放电的存在与年龄、睡眠、神经和/或智力合并症呈正相关。
癫痫样活动的患病率因儿童年龄而异。睡眠EEG作为首次记录具有优势，尤其是在非常年幼的儿童或有神经合并症的儿童中。
与其他类型的睡眠EEG相比，褪黑素诱导的睡眠EEG具有更高的诊断阳性率。年龄、癫痫发作症状学和合并症影响EEG方法的选择。
