Usefulness Of Sleep-Deprived Eeg In The Diagnosis Of Seizure Disorders In Children

The provocative effects of sleep deprivation (SD) on patients with seizure disorder and on the electroencephalogram (EEG) are well known.The purpose of the study was to test its routine use and usefulness in the pediatric and adolescent age group with, or suspect of having, seizure disorder, especially those presenting with first unprovoked seizure. Between September 2000 and November 2002, among patients referring to the author's clinic and the Pediatric Emergency Department of Nemazi Hospital, Shiraz, 598 children and adolescents were randomly assigned to a 10-minute surface EEG, either routinely, or after a period of partial or total SD. Those who refused or could not tolerate the SD procedure entered the routine group. The EEG's were analyzed for the presence of epileptic abnormality. Of 598 patients, 544( 91%) had clinical seizures; the rest (54, 9%) were seizure suspects or had seizure "mimickers" (syncope, night terrors, pseudo-seizures, etc). Of seizure patients, 210 ( 38.6 % ) suffered from a first unprovoked seizure, and the rest (334, 61.4%) had more than one seizure episode at the time of EEG performance. Abnormal epileptiform EEG's were more frequently seen in the group of seizure patients who were sleep-deprived before performing the EEG, as compared to the routine group. Conversely, more normal EEG's were seen upon routine performance of EEG ( p value <00001, χ2 = 76.5). Similarly, more abnormal sleep-deprived EEG's were seen in patients with first unprovoked seizure than when EEG was done routinely in this subgroup of patients. Patients with complex partial seizure had significantly more abnormal EEG's when subjected to SD (p