Children with epilepsy, abnormalities on EEG without seizures

Epilepsy and Children

The term “convulsive readiness” is currently considered to be incorrect, as different specialists may imply different changes to EEG under this term. A more precise description of the detected violations is needed.

If epileptiform activity (changes characteristic of epilepsy) is detected on EEG, the interpretation of these changes depends on the individual clinical situation.

In most cases, treatment is prescribed only when the patient has seizures accompanied by epileptic activity on EEG. As a rule, if changes in EEG are detected, and there are no clinical manifestations of seizures, treatment should not be prescribed, since asymptomatic changes in EEG (characteristic of epilepsy, but not accompanied by seizures) do not indicate that in the future this person will necessarily have seizures. Pathological changes in EEG (focal or generalized epileptiform activity) can be detected in approximately 1% of healthy people without signs of nervous system diseases (this percentage is higher among children); minimal nonspecific EEG abnormalities can be detected in approximately 10-15% of all people in the population. When conducting EEG about any complaints (such as headache, etc.), but without clinical signs of epilepsy, epileptiform activity is detected in 2-3% of cases.

However, there are rare exceptions when epileptic activity (detected, as a rule, during sleep and very pronounced, almost constant, reaching the degree of epileptic status) is not accompanied by the occurrence of seizures, but prevents the normal development of the child, leads to a violation of academic performance in school, memory and speech. Such forms of the disease have been discovered in recent years. These include: Landau-Kleffner syndrome (acquired epileptic aphasia), ESES (electrical status of slow-wave sleep) and other uncontrolled epileptic encephalopathy, manifested by mental disorders, behavior, memory impairment, learning difficulties against the background of characteristic changes in the EEG and in the absence of attacks. In these exceptional cases, changes in the pattern of EEG, even in the absence of attacks, serve as an indication for the appointment of antiepileptic drugs.

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