Paroxysmal non-epileptic events in children: A retrospective study over a period of 10 years

Objective: To determine the frequency, nature and clinical characteristics of paroxysmal non-epileptic events in children diagnosed by video electroen cephalogram (EEG) monitoring at a tertiary referral centre. Methodology: A retrospective study of children with paroxysmal non-epilepti c events, aged 2 weeks to 17 years inclusive was undertaken. The study grou p consisted of children who had video EEG monitoring during a 10-year perio d (1988-99). Telemetry files, medical charts, events recorded on video and record sheets were reviewed. Results: A total of 666 children were analysed, 269 had epileptic events re corded, 285 had non-epileptic events and 112 had no events recorded. In chi ldren with non-epileptic events, 43% were developmentally delayed, 25% had an abnormal neurological examination and 40% had epilepsy. In the study sam ple an epileptiform interictal EEG was common (24%). The major subgroups of non-epileptic events were: staring (34%), sleep phenomena - benign sleep m yoclonus (15%), arousals (13%), motor tics (11%) and shuddering (7%). Devel opmental delay (57%) was common in children who presented with staring spel ls. A diagnosis of a specific non-epileptic event was reached in 96% of cas es. Conclusion: Paroxysmal non-epileptic events can cause diagnostic confusion, particularly in children with developmental delay, epilepsy or an epilepti form EEG. Accurate diagnosis can be reached in the majority of cases using video EEG monitoring.