Bioelectric activity of the brain in children and adolescents with pseudoepileptic seizures

Objective: Pseudo-epileptic seizures are a very crucial clinical problem in the developmental age and are coexisting with epileptic seizures in children. There is no answer to the question if the appearance of pseudoepileptic seizures in this age is connected to bioelectric brain function disorders. In adults with pseudoepileptic seizures the temporal area disorders are detected.

Methods: The video EEG was performed in 36 girls and 4 boys aged 8 to 18 years (average 13 years). The most frequent types of pseudo seizure were syncope (30%), fainting (15%), abdominal pain (10%) and visual disturbances (10%). In 7.5% clonic and tonic-clonic seizures and in 2.5 % paroxysmal sense disorders were seen. Confusion of place and time and paroxysmal behavioral disorders in 5%. In 3 cases hyperventilation was observed. In 15/40 with pseudoseizures epilepsy was coexisting. Methods: In all children 1 hour interictal videoEEG monitoring was performed. The pattern was done during waking state and all children was activated. In 15, the procedure were repeated after sleep deprivation in physiological sleep. We analysed the basic activity, reactivity, symmetry and synchrony in the EEG patterns, presence of the epileptic-like grapho-elements and paroxysmal discharges. In sleep patterns the bioelectrical features, stages, epileptic-like and paroxysmal graphoelements are assessed.

Results: In 40% children with pseudoepileptic seizures, abnormalities of the interictal EEG were seen. Sleep deprivation provoked the abnormalities in another 4/15 children. In this pattern 27.5% children had localized paroxysmal discharges, and 22.5% generalized. In most of the cases the EEG was sensitive to stimulation.

Conclusions: Pseudoepileptic seizures appear mostly in girls. One half of these cases had basic EEG pattern and paroxysmal bioelectric abnormalities, however 12/20 of them had epileptic seizures as well.