Evaluation of the application value of video-electroencephalogram monitoring in the diagnosis and localization of pediatric epilepsy / 中国医师进修杂志

ABSTRACT

Objective:To explore the application value of video-electroencephalogram(VEEG) monitoring in the diagnosis and localization of children with epilepsy.Methods:The clinical data of 310 children with clinical epilepsy symptoms diagnosed and treated in Tangshan Maternal and Child Health Care Hospital and Qilu Children′s Hospital Affiliated to Shandong University from May 2018 to April 2020 were analyzed. All children underwent routine EEG (REEG), VEEG monitoring, and positron emission computed tomography (PET-CT) for children undergoing surgery. REEG and VEEG was compared to monitor epileptic form discharges; the location of epileptic lesions was compared by different examination methods, and children were followed up after surgery.Results:Among the 310 children, 247 children were diagnosed with epilepsy and 63 children were suspected of epilepsy. The detection rate of VEEG epileptic form discharge was higher than that of REEG 87.4% (216/247) vs. 45.7% (113/247), and the difference was statistically significant ( χ2 = 6.3042, P<0.05). Among 247 children with epilepsy, during the VEEG test, 81 children (32.8%) had clinical symptoms, of whom 65 had seizures and 16 had non-epileptic seizures. The detection rate of VEEG for epilepsy was higher than that of clinical seizures 87.5% (216/247) vs. 32.8% (81/247), and the difference was statistically significant ( χ2 = 8.6148, P<0.05). Among the 247 children with epilepsy diagnosed, 144 children had epilepsy syndrome, temporal lobe epilepsy accounted for 54.17% (78/144), and frontal lobe epilepsy accounted for 34.2% (50/144). The accuracy of preoperative VEEG localization of epilepsy lesions in 50 children undergoing surgery was higher than that of PET-CT and REEG 80.0% (40/50) vs. 56.0% (28/50), 54.0% (27/50), and the differences were statistical significance ( χ2 = 5.3014, 5.6031, P<0.05). Postoperative follow-up of 50 children who had underwent surgery showed that 50.0% (25/50) of the children had no seizures, and 38.0% (19/50) of the children had significant improvements in postoperative seizure time, seizure period, and clinical manifestations. 12.0% (6/50) of the children had no significant improvement in clinical symptoms. Conclusions:VEEG can improve the detection rate of epileptic form discharges, and provide an important basis for clinical diagnosis of epilepsy, and have important value in locating epilepsy lesions before surgery.