Electroencephalogram Abnormalities in Very Young Children with Acute Hepatitis A Infection: A Cross-Sectional Study

Shahramian, Iraj; Mohammadi, Mohammad Hasan; Akbari, Alireza; Sargazi, Alireza; Delaramnasab, Mojtaba; Bazi, Ali

doi:10.5812/compreped.83761

Cited by 3 publications

(3 citation statements)

References 25 publications

(37 reference statements)

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“…In adult studies, the EEG findings of encephalopathy have been staged as alpha coma, triphasic wave, and periodic patterns; however, these abnormal morphologies were not common in children. On the other hand, the pediatric EEG findings include varying degrees of slowing, unresponsiveness to external stimuli, and discontinued activity [22,23]. In our study, we classified encephalopathic EEG findings into three stages, normal, diffuse slowing, and voltage suppression, which is different from the adult EEG abnormalities.…”

Section: Discussionmentioning

confidence: 92%

“…EEG is a valuable diagnostic technique in the identification of encephalopathies. In addition, EEG abnormalities in children occur earlier than in adults [22]. In adult studies, the EEG findings of encephalopathy have been staged as alpha coma, triphasic wave, and periodic patterns; however, these abnormal morphologies were not common in children.…”

Section: Discussionmentioning

confidence: 99%

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The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure

Özgör,

Gungor,

Aladağ

et al. 2024

Cureus

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BackgroundPediatric acute liver failure (PALF) is still life-threatening and requires urgent care. The presence of encephalopathy is a clinical diagnosis, but it is more difficult to diagnose in children than in adults, and an electroencephalogram (EEG) can be invaluable. The role of EEG in managing the treatment of patients with PALF, other than the identification of encephalopathy, is unknown. This study aimed to investigate patients' EEGs, which may guide in choosing the most appropriate treatment in encephalopathy children. A further aim was to investigate a new score method, based on the laboratory results, which might indicate the presence of encephalopathy in cases with PALF. MethodsMedical data of 33 PALF patients followed in our clinic were reviewed retrospectively. This study included 33 patients, whose EEG recording was taken on the first day of supportive treatment due to liver failure in the pediatric intensive care unit (PICU). The EEG findings were categorized into three classes: normal, epileptic and non-epileptic paroxysmal, and background encephalopathic patterns including widespread slowing and voltage suppression. ResultThis retrospective study included 13 male and 20 female patients with a mean age at presentation of 4.82±4.81 months whose EEG was performed on the first day of supportive therapy for liver failure in the PICU. The EEG findings were categorized into three groups: normal, epileptic and non-epileptic paroxysms, and encephalopathic patterns including diffuse background slowing and voltage suppression. Comparing EEG findings and treatments, we found that the normal EEG group responded well to liver-supporting therapy and the rate of plasmapheresis treatment was significantly higher in the diffuse slowing group. Patients with diffuse slowing of the EEG were 9.6 times more likely to receive plasmapheresis. We found that above a cut-off of ≥7.5 for the TAI (total bilirubin, albumin, and international normalized ratio (INR)) score used in our study, the risk of developing encephalopathy increased 14.4-fold. ConclusionsIn PALF, EEG findings can provide findings that will help clinicians in determining treatment selection and prognosis, as well as detecting epileptic focus and encephalopathy. The TAI score can be used to assess the risk of encephalopathy in cases of PALF, when it is challenging to identify encephalopathy or when an EEG is not possible.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure

Özgör,

Gungor,

Aladağ

et al. 2024

Cureus

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“…Evidence has shown that EEG can be used as a sensitive and reliable method for screening brain and nerve disorders (10). Many studies have mentioned EEG abnormality as a primary diagnostic sign for brain dysfunction in the absence of overt hepatic encephalopathy (OHE) or minimal hepatic encephalopathy (MHE) (11,12).…”

Section: Introductionmentioning

confidence: 99%

Electroencephalogram in cirrhotic children without clinical encephalopathy

Shahramian,

Mohammadi,

Aminisefat

et al. 2024

Preprint

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Introduction Cirrhosis is one of the most common causes of hospitalization and death in children, so prevention of progressive liver diseases such as hepatic encephalopathy (HE) is critical. In addition to overt HE, subclinical hepatic encephalopathy (SHE) and mild hepatic encephalopathy (MHE) are stages of HE that can only be diagnosed by psychometric and neurophysiological tests, and with early diagnosis and treatment, daily functioning of patients will improve. Therefore, purpose of this study is determining electroencephalogram (EEG) findings in children with cirrhosis without clinical encephalopathy. Methods This study was conducted observationally at Amir Al Momenin Zabol Hospital, Zabol University of Medical Sciences, Iran. In this study, 50 children with cirrhosis without encephalopathy symptoms and 50 healthy children were examined for abnormal electroencephalogram findings. Finally, the data were analyzed using SPSS V22 software. Results The mean and standard deviation of study population age was 57.6 ± 76.17 months. Of a total of 50 children with cirrhosis, 21 (42%) had abnormal EEG findings, whereas no child in the healthy group had abnormal EEG findings. There was a significant association between abnormal EEG findings and older age (P = 0.001), underlying autoimmune hepatitis disease (P = 0.011), and abnormal (elevated) serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) .Children with cirrhosis who had abnormal EEG findings had a higher mean Pediatric End-Stage Liver Disease (PELD) score (18.1 ± 4.1) than patients with normal EEG findings (17.2 ± 3.7), but these findings was not statistically significant or remarkable ( P = 0.073). The sensitivity of EEG for predicting the severity of cirrhosis was estimated to be 70% and the specificity to be 65%. Conclusion The results of this study demonstrate that the higher sensitivity of EEG compared to the specificity in predicting the severity of cirrhosis indicates that EEG can be used to exclude severe cirrhosis or to screen cirrhotic patients at risk of deterioration than in confirming its diagnosis.

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Prevalence of epileptiform electroencephalographic abnormalities in people without a history of seizures: A systematic review and meta‐analysis

Aschner,

Kowal,

Arski

et al. 2024

Epilepsia

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Abnormal patterns identified on electroencephalogram (EEG) are one of the primary diagnostic tests for epilepsy. However, epidemiological studies have established that both benign and epileptiform abnormalities (EA), occur in the EEG of non‐epileptic, seizure‐free people as well. The reported rates of EAs in non‐epileptic, seizure‐free populations vary, and the true prevalence is unknown. The primary objective of this systematic review and meta‐analysis was to estimate the overall prevalence of EAs in the EEG of people without a history of seizures. Secondary aims were to characterize i) the cortical localization of focal abnormalities; ii) the proportion of findings that occurred during standard EEG stimulation protocols; and iii) the persistence and implications of abnormalities at follow‐up. A comprehensive electronic search of six bibliographic databases was completed: EMBASE, MEDLINE, PsycINFO, Cumulated Index of Nursing and Allied Health Literature, The Cochrane Central Register for Controlled Trials, and Web of Science. No search date restrictions were applied. Overall effect size was calculated using a generalized linear mixed‐effects model. Fifty‐three studies, totalling 73,990 individuals, met our inclusion criteria. The overall point prevalence of EAs was 1.74% (95% CI: 1.13‐2.67). Due to the risk of bias in the literature, especially from participant selection, we believe this to be an overestimate of the true prevalence. Prevalence of EAs was greater in children (2.45%, 1.41‐4.21) and the elderly (5.96%, 1.39‐22.13) compared with adults (0.93%, 0.48‐1.80). Reports of developing epilepsy after an EA‐positive EEG were rare. The likelihood of subsequent positive findings on follow‐up EEG may be as high as 50%. Our study has limitations in that males were overrepresented in the study samples, there is substantial heterogeneity among studies, and many studies provided insufficient detail about their exclusion criteria. Nonetheless, our estimates provide benchmark data for future studies examining EAs in clinical populations, particularly behavioural and psychiatric populations.

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Electroencephalogram Abnormalities in Very Young Children with Acute Hepatitis A Infection: A Cross-Sectional Study

Cited by 3 publications

References 25 publications

The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure

The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure

Electroencephalogram in cirrhotic children without clinical encephalopathy

Prevalence of epileptiform electroencephalographic abnormalities in people without a history of seizures: A systematic review and meta‐analysis

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