Analysis of video electroencephalography and imaging characteristics in children with drug-refractory epilepsy
Objective To compare the detection rates of epileptogenic foci in drug-refractory epilepsy children using video electroencephalography(VEEG),MRI and PET.Methods The 24 h and 2 h VEEG,MRI and PET/CT or PET/MRI were conducted for 70 children with drug-refractory epilepsy in Children's Hospital of Nanjing Medical University from January 2020 to April 2022,and Raven's Standard Progressive Matrices(SPM)or Developmental Screening Test for Child under six(DST)based on their age(＜5 or ≥ 5 years old)were assessed for intelligence.Results Among 70 children,44 seizures were detected during 24 h VEEG,while 31 seizures were detected during 2 h VEEG,and there was statistically significant difference between the two methods(x2=5.760,P=0.015).The consistency of diagnosing single location/unilateral abnormalities,bilateral abnormalities,or normal results was poor among VEEG,MRI and PET/CT or PET/MRI(κ=0.194,P=0.000),and the difference among the three methods was statistically significant(x2=33.068,P=0.001).The VEEG(x2=25.000,P=0.000)and PET/CT or PET/MRI(x2=11.764,P=0.002)had higher diagnostic capabilities than MRI,and PET/CT or PET/MRI had higher diagnostic capability than VEEG(x2=8.048,P=0.014).There were 41 children(58.57％)showed mental retardation,among them children with onset age≤2 years had a higher rate compared to those with onset age＞2 years(x2=6.193,P=0.013),and children with abnormal VEEG background had a higher rate compared to those with normal VEEG background(x2=4.868,P=0.027).Conclusions The detection rate of epileptiform discharges and clinical seizures can be increased by lengthening VEEG time at each time and increasing the number of times of VEEG.PET/CT or PET/MRI and VEEG can provide localization information of epileptic foci of children whose MRI results are negative.The mental retardation rate of children who have onset age≤2 years and of abnormal VEEG background is higher.
Drug resistant epilepsyElectroencephalographyMagnetic resonance imagingPositron-emission tomographyChild
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