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E.E.G.IN PAEDIATRICS_AN IMPORTANT INVESTIGATION
MAHAPEDICON 2005

Dr. Manoj Rathi

MD(Ped),FICMCH
Aashirwad Children Hospital,
Mudholkar Peth, Amravati


With the advances in pediatric neuroscience, pediatric EEG has become an important investigation. In my article I had discussed interpretational of common neurological disorders.

Major Frequence Ranges of Rhythms :

Electrical activity from the brain consists primarily of rhythms and these rhythms are named according to their frequency in cycles per second (C/sec), also called Hertz Hz).
  • Delta refers to all rhythms less than 4 c/sec
  • Theta is between 4 to <8 c/sec
  • Alpha is between 8 to 13 c/sec.
  • Beta is> 13 c/sec.
      Normal Background Rhythms-Introduction
      Usually, there is one dominant frequency that is called the 'background rhythm'.
1. Background rhythm in wake
    In infants = 4 to 5 c/sec. (Delta and Theta waves)
    In children = 5 to 8 c/sec. (Theta)
    In adults = 8 to 10 c/sec. (Alpha)
2. Background rhythm is sleep
    In light sleep = 5 to 6 c/sec. (Theta)
    In deep sleep = 2 to 3 c/sec. (Delta)
(A) Abnormal Patterns - Introduction:
Abnormal patterns are mainly divided into two types:
    1. Slow waves and
    2. Spikes (or-sharp waves)
Also, depression of normal rhythm's may be abnormal.

(I) Slow Waves:

Slow waves are rhythms appearing especially during wakefulness that are slower than in the normal. Abnormal slow waves appear when the brain cells are damaged.

(II) Paroxysms: Spikes (Sharp Waves):

The spike (or Sharp wave) is a suddenly appearing electrical explosion that looks like a spike of large nail, spikes are <70 m sec and sharp wave 70 to 200 m sec in duration. These two patterns signify an epileptogenic region of the brain.

(III) Depression of normal Rhythms - Decreased amplitude of any normal rhythms.
    Diffuse slow - suggestive of metabolic, toxic, infectious etiologies.
    Focal slow-very slow - space occupying lesion.
B) Summary of Abnormal EEG Patterns and associated clinical conditions:
SHARP PAROXYSMALACTIVITY-NEONATAL:
  1. Multi focal spikes - (non specific) Seizures.
  2. Repetitive spike-Clonic seizure
  3. Slow delta discharge-tonic seizure
POST NATAL:
  1. Hypsarrhythmias-Infantile spasms.
  2. Slow (1 to 2/sec.) spike and wave-Lennox-Gastaut syndrome (tonic seizure)
  3. 3.3/sec.spike and wave complex-absence (Multiple spike-generalized tonic clonic seizure)
  4. Occipital spikes - Visual perceptual disorders
  5. Centro temporal sharp waves-benign epilepsy of childhood.
  6. Periodic Lateralized epileptiform discharge - Cerebrovascular emboli and also epilepsia partialis continua, meta static to mores.
  7. Temporal sharp waves
Posterior
Mid temporal
Anterior
Seizures
Navigate Symptoms & Seizures
P Psychomotor & generalized
   
   
Tonic clonic seizures


© META BOLIC, INFECTONS AND TOXIC ETIOLOGIES:
These are diffuse slow waves, decreased frequency of back ground rhythm.

(D) VASCULAR:
  • Carotid-Frontal and temporal slow waves
  • Vertibrobasilar-Temporal and occipital show waves and low amplitude
  • Haemorrhage-SharrJwaves or spikes with slow waves
  • Space occupying lesion-highly localized abnormal slow waves.
(E) MENTAL & LEARNING DISABVITIES:
Occipital slow waves and extreme spindles.

(F) SENILITY:
Decreased frequency-of back ground rhythm and temporal slow waves on the left side of brain.


Last Updated on 15-07-2006

How to cite this url
Mahapedicon 2005 - Conference Abstracts.Pediatric Oncall [serial online] 2006 [cited 15 July 2006(Supplement 7)];3. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
MAH_PEDICON2006/eeg1_in_pediatrics.asp
 
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