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Frequency of Epileptiform Discharges in the Sleep-Deprived Electroencephalogram in Children Evaluated for Attention-Deficit Disorders

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The authors determined the frequency of epileptiform discharges in the electroencephalogram (EEG) of a cohort of children and adolescents referred to a neurology specialty clinic for evaluation of attention-deficit disorders. Of 624 records, 461 (73.9%) were normal and 163 (26.1%) abnormal. Of abnormal EEGs, 70 (42.9%) had focal epileptiform discharges only, 68 (41.7%) had generalized epileptiform discharges only, and 19 (11.6%) had both independent focal and generalized spikes. Focal spikes were localized chiefly in central, frontal, and temporal regions. Of 163 records with abnormalities, 154 (94.5%) were sleep deprived and 159 (97.5%) were sleep records. One-quarter of the nonepileptic children evaluated for attention-deficit disorder have epileptiform discharges in the EEG, and just more than half are focal. Sleep-deprived sleep is essential to exclude epileptiform abnormalities. The utility of the EEG in the management of attention-deficit disorders and selection of stimulant or nonstimulant medication deserves further study.
Title: Frequency of Epileptiform Discharges in the Sleep-Deprived Electroencephalogram in Children Evaluated for Attention-Deficit Disorders
Description:
The authors determined the frequency of epileptiform discharges in the electroencephalogram (EEG) of a cohort of children and adolescents referred to a neurology specialty clinic for evaluation of attention-deficit disorders.
Of 624 records, 461 (73.
9%) were normal and 163 (26.
1%) abnormal.
Of abnormal EEGs, 70 (42.
9%) had focal epileptiform discharges only, 68 (41.
7%) had generalized epileptiform discharges only, and 19 (11.
6%) had both independent focal and generalized spikes.
Focal spikes were localized chiefly in central, frontal, and temporal regions.
Of 163 records with abnormalities, 154 (94.
5%) were sleep deprived and 159 (97.
5%) were sleep records.
One-quarter of the nonepileptic children evaluated for attention-deficit disorder have epileptiform discharges in the EEG, and just more than half are focal.
Sleep-deprived sleep is essential to exclude epileptiform abnormalities.
The utility of the EEG in the management of attention-deficit disorders and selection of stimulant or nonstimulant medication deserves further study.

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