Muhammad Akbar Malik, Muhammad Haroon Hamid, Tahir Masood Ahmed, Naseer Ahmed, Ghazala Hanif, Qurban Ali.
Seizure type and EEG pattern compatible with Subacute Sclerosing Panencephalitis among children having unexplained seizures.
Pak Paed J Jan ;31(4):182-9.

Background: Knowing the neuroepidemiology, single case of SSPE would mean a very high incidence of measles infection in the community. AIMS: Correlation of seizure type and EEG patterns in diagnosing SSPE among children having unexplained seizures. Design: Cross Sectional Observational Study. Place and duration: Department of the Paediatric Neurology, The Children`s Hospital, Lahore Pakistan from 1st Sept 2005 to 31st May 2007 (20 months) Patients & Methods: All children age, 2 years-16 years, having unexplained seizures referred for 1st diagnostic EEG testing were included. All the children having clinical suspicion and EEG findings suggestive of SSPE were admitted in neurology wards for serum-CSF antimeasles antibody titers evaluation. The diagnosis of SSPE was confirmed according to Dyken`s criteria. Results: A total of 4200 (60% boys) children having unexplained seizures referred for first diagnostic EEG records were our study population. Among this total, 6% of the children had clinically myoclonic seizures. First abnormal EEG records were observed among 37% of the total (girls 54%) but these records were abnormal in 74% of the myoclonic patients as compared with 35% of the non-myoclonic patients. Among the total 1544 abnormal EEGs, 96 EEG were suggestive of SSPE, and 42% of these patients with abnormal EEG records were among the myoclonic patients. Out of these 96 patients, serum-CSF antimeasles antibody titers were diagnostic in 40 of the patients (male: female ratio of 2.33:1). Among these 40 SSPE patients, 50% of these children had characteristics burst suppression pattern, 45% had atypical finding and 5% had findings of non-convulsive status epilepticus on their first diagnostic EEG records. Conclusion & recommendation: Subacute Sclerosing Panencephalitis (SSPE) patients also may have atypical EEG findings. Children having myoclonic seizures and EEG records showing burst suppression pattern are more likely to have SSPE and we recommend earlier referral of such patients to tertiary paediatric neurology department for thorough investigations and optimal care.

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