Journal of child neurology
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The use of video-electroencephalography for the evaluation of children is reserved for inpatients with intractable "seizures." Prolonged video-electroencephalographic monitoring is used to ascertain whether the events are epileptic in nature, or to evaluate the medically intractable patient with epilepsy for surgical management of seizures. The increasing interest in the evaluation of patients with intractable epilepsy and recent technologic advances have led to a greater sophistication and versatility in patient evaluation. This paper reviews currently available technologies and newer digital acquisition and playback systems, and discusses ways of optimizing the evaluation of patients with intractable seizures.
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This report presents a brief description and classification of status epilepticus. This neurologic emergency occurs more frequently in young children and elderly adults, although patients of all ages may experience prolonged seizures. ⋯ The morbidity and mortality of status epilepticus are significant and directly dependent upon prompt and appropriate medical therapy. Advances in understanding various aspects of status epilepticus may lead to improved outcome for affected patients.
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Noninvasive assessment of children with chronic epilepsy is often imprecise and localization of seizure foci requires intracranial electroencephalographic monitoring. Subdural electrodes provide coverage of large areas of neocortex and are ideally suited for evaluating children with intractable epilepsy and to functionally map critical cortex. This report discusses the role of subdural electroencephalography in the evaluation of childhood epilepsy.
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An 8-year-old boy developed generalized tonic spasms lasting minutes accompanied by an electrodecremental event on electroencephalogram in association with increased intracranial pressure caused by shunt malfunction. The electroencephalographic abnormalities and clinical attacks occurred despite an otherwise normal neurologic examination, normal initial opening pressure on lumbar puncture and shunt tap, and only mild ventricular dilation revealed by brain imaging. ⋯ After revision of the shunt "seizures" stopped and the electroencephalogram returned to normal. Antiepileptic drugs were discontinued, with no recurrence of events.