Evaluation of dynamic electroencephalogram monitoring and MRI in localized diagnosis of epilepsy in children
Objective To analyze the application value of ambulatory electroencephalogram(AEEG)and magnetic reso-nance imaging(MRI)in the localization diagnosis of pediatric epilepsy.Methods Fifty suspected epileptic children who were diagnosed and treated in the Sanmenxia Central Hospital from January 2021 to December 2022 were selected,and all underwent brain MRI and AEEG examinations to analyze the epileptiform discharge of the children during AEEG examina-tion.Using clinical comprehensive diagnostic results as the gold standard,analyze the diagnostic accuracy,sensitivity,and specificity of MRI and AEEG in pediatric epilepsy.Results Among 50 suspected children with epilepsy,38 cases were confirmed by clinical comprehensive diagnosis,12 cases were negative.MRI showed abnormal results in 39 cases,including 34 true positive cases,5 false positive cases,7 true negative cases and 4 false negative cases.AECG detected 38 abnormal cases,including 36 true positive cases,2 false positive cases,10 true negative cases and 2 false negative cases.Kappa consistency test showed that the consistency between MRI examination and clinical comprehensive diagnosis was moderate(Kappa=0.492,P＜0.05),while the consistency between AECG and clinical comprehensive diagnosis was strong(Kappa=0.781,P＜0.05).The sensitivity,specificity and accuracy of AEEG in the diagnosis of pediatric epilepsy were 94.74％,83.33％,92.00％,94.74％and 83.33％,respectively.The sensitivity,specificity and accuracy of MRI in the diagnosis of pediatric epilepsy were 89.47％,58.33％and 82.00％,respectively.The positive predictive value was 87.18％and the negative predictive value was 63.63％(P＞0.05).The area under the curve(AUC)of AEEG for diag-nosis of pediatric epilepsy was 0.890,higher than that of MRI(0.739).Among 36 true positive children detected by AECG,the detection rate of epileptic discharge was 69.44％(25/36),and the detection rate of epileptic discharge in sleep was higher than that in awake period.Conclusion Both AEEG and MRI have good diagnostic effects for pediatric epilepsy,but the diagnostic effect of AEEG is relatively better.If necessary,the two can be combined to better determine the condition of the child.
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