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KMID : 1130320080510010062
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Korean Journal of Pediatrics
2008 Volume.51 No. 1 p.62 ~ p.66
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Usefulness of video-EEG monitoring in paroxysmal nonepileptic events of children and adolescents
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Lee Jee-Yeon
Lee Hee-Sun
Choi Wook-Sun
Eun So-Hee
Lee Kee-Hyoung
Eun Baik-Lin
Lee Joo-Won
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Abstract
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Purpose: In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders
can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring.
Methods: From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric
Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video- EEG monitoring for more than 3 months.
Results: Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The meanage of patients was 7.2±5.8 years. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P<0.05). Psychogenic disorder was more frequent in female (n=6) than in male (n=2) but there was no statistical significance (P>0.05).
Conclusions: Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided. (Korean J Pediatr 2008;51:62-66)
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KEYWORD
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Paroxysmal nonepileptic event, Video-EEG monitoring
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