Clinical Scoring for Prediction of Abnormal Electroencephalography in Pediatric Patients with Seizure in Chaiyaphum Hospital
DOI:
https://doi.org/10.64960/srimedj.v41i1.269625Keywords:
pediatric seizures, electroencephalography, abnormal EEG, clinical score, prediction modelAbstract
Background and Objectives: Pediatric epilepsy is a significant public health issue. Electroencephalography (EEG) is a highly valuable tool for supporting the diagnosis and treatment of epilepsy. Limited EEG availability at many hospitals often necessitated patient referral to a tertiary care center. This study aimed to identify factors associated with abnormal EEG findings and to develop a clinical scoring system to predict abnormal EEG in children presenting with seizures.
Methods: This was a prognostic prediction research study, retrospectively collected data from the medical records of pediatric patients with seizures who were admitted to Chaiyaphum Hospital and underwent an EEG between January 1, 2022, and December 31, 2024. Patients were divided into two groups: normal EEG and abnormal EEG. Data analysis involved descriptive statistics and a multivariable risk difference regression approach to identify prognostic factors and assess the model's performance.
Results: Out of 60 patients, 18 (30%) had abnormal EEG findings. Five predictive factors associated with abnormal EEG (focal seizure, absence seizure, age of seizure onset ≥72 months, age <72 months, no fever) were identified and used to create a clinical scoring system. The system categorized patients into a low-risk group (<3 points) and a high-risk group (≥3 points). The scoring system showed an AUC (area under the receiver operating characteristic curve) of 0.789 (95% CI 0.655, 0.923) and demonstrated good predictive validity.
Conclusion: This study successfully developed an effective scoring system based on five prognostic factors (focal seizure, absence seizure, age of seizure onset ≥72 months, age <72 months, no fever) to predict abnormal electroencephalography (EEG) in children presenting with seizures. The scoring system may be used to help decide which patients with a high-risk score (≥3 points) should be referred for an EEG at a hospital with higher capability.
References
Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord 2015;17(2):117-23. doi:10.1684/epd.2015.0736.
Asawavichienjinda T, Sitthi-Amorn C, Tanyanont W. Prevalence of epilepsy in rural Thailand: a population-based study. J Med Assoc Thai 2002;85(10):1066-73.
Sa-ui W. The effectiveness of educational program using cartoon animation video for caregivers of children with epilepsy on epilepsy knowledge of caregivers among children with epilepsy [Abstract in Thai]. J Dept Med Serv 2022;47(2):53-60.
Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014;55(4):475-82. doi:10.1111/epi.12550.
Hirstz D, Ashwal S, Berg A, Bettis D, Camfield C, Camfield P, et al. Practice parameter: evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcommittee of the American Epilepsy Society. Neurology 2000;55(5):616-23. doi:10.1212/WNL.55.5.61.
Fatih M, Akif Ö, Ülkühan Ö, Ergin A, Erhan A, Halil Ç, et al. Characteristics and clinical value of early eletroencephalography (EEG) after a first unprovoked seizure in children. Neurophysiologie Clinique 2023;53(1):1-6. doi:10.1016/j.neucli.2023.102848.
Hatchaleelaha S. EEG in children with complex febrile convulsion in Ratchaburi Hospital. Region 4 Medical Journal 2002;21(4):207-12.
Camfield P, Camfield C, Dooley J, Tibbles J, Fung T, Garner B. Epilepsy after a first unprovoked seizure in childhood: Neurology 1985;35(11):1657-60. doi:10.1212/WNL.35.11.1657.
Berg A. Risk of recurrence after a first unprovoked seizure. Epilepsia 2008;49(s1):13-8. doi:10.1111/j.1528-1167.2008.01444.x.
Shinnar S, Berg A, Moshé S, Petix M, Maytal J, Kang H, et al. Risk of seizure recurrence following a first unprovoked seizure in childhood: a prospective study. Pediatrics 1990;85(6):1076-85. doi:10.1542/peds.85.6.1076.
Shinnar S, Kang H, O'Dell C. EEG abnormalities in children with a first unprovoked seizure: a prospective study. Epilepsia 1994;35(3):471-6. doi:10.1111/j.1528-1157.1994.tb02464.x.
Noman A, Sohaib H, Syed M, Murk S, Ahmed R, Salman M, et al. Predictors of abnormal electroencephalogram and neuroimaging in children presenting to the emergency department with new-onset afebrile seizures. BMC Pediatr 2022;22(1):619. doi:10.1186/s12887-022-03668-6.
Kuturec M, Emoto ES, Sofijanov N, Dukovski M, Duma F, Ellenberg JH, et al. Febrile seizures: is the EEG a useful predictor of recurrences? Clin Pediatr (Phila) 1997;36(1):31-6. doi:10.1177/000992289703600105.
American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 1996;97:769–72.
Natsume J, Hamano S-I, Iyoda K. New guidelines for management of febrile seizures in Japan. Brain Dev 2017;39:2-9. doi:10.1016/j.braindev.2016.06.003.
Kaushik J, Sondhi V, Yoganathan S, Dubey R, Sharma S, Vinayan K, et al. Association of Child Neurology (AOCN) Consensus Statement on the Diagnosis and Management of Febrile Seizures. Indian Pediatr 2022;59(4):300-6. doi:10.1007/s13312-022-2497-2.
Corsello A, Marangoni M, Macchi M, Agostoni C, Milani G, Dilena R, et al. Febrile Seizures: A Systematic Review of Different Guidelines. Pediatric Neurology 2024;155:141-8. doi:10.1016/j.pediatrneurol.2024.03.024.
Unterberger I, Trinka E, Kaplan PW, Walser G, Luef G, Bauer G. Generalized nonmotor (absence) seizures-What do absence, generalized, and nonmotor mean? Epilepsia 2018;59(3):523-9. doi:10.1111/epi.13996.
Matricardi S, Verrotti A, Chiarelli F, Cerminara C, Curatolo P. Current advances in childhood absence epilepsy. Pediatr Neurol 2014;50(3):205-12. doi:10.1016/j.pediatrneurol.2013.10.009.
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