Electroencephalography in the differential diagnosis of non-epileptic paroxysmal events in infants: clinical utility and other predictors
Seizure, cilt.136, ss.77-85, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 136
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.seizure.2026.02.006
- Dergi Adı: Seizure
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Psycinfo
- Sayfa Sayıları: ss.77-85
- Anahtar Kelimeler: Electroencephalography, Seizures, Infant, Non-epileptic paroxysmal events, Breath holding spells, Anemia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background Differentiating non-epileptic paroxysmal events (NEPE) from epileptic seizures in infants is challenging, especially in the 1–24 month age group where features overlap and data are limited. Meanwhile restricting studies to the first year may lead to overlook the events that persist into the second year. This study aimed to define the clinical spectrum of NEPE, assess diagnostic yield of electroencephalography (EEG), and identify predictors of specific subtypes. Methods This single-center, retrospective study included infants aged 1–24 months who underwent EEG for suspected NEPE between January 2015 and March 2021. Demographic, clinical, laboratory, neuroimaging, and EEG data were analyzed per Strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. Results Of 5614 infants assessed, 1465 underwent EEG, and 216 (mean age 11.1 ± 6.5 months; 55.1% male) met inclusion criteria. Breath holding spells (BHS) were most frequent (55.1%), followed by jitteriness (10.6%) and shuddering attacks (9.3%). Crying was the predominant trigger for BHS (97.5%, p < 0.001). EEG was abnormal in 8.8% of patients. Anemia was present in 23.4%. Independent predictors of BHS were crying (AOR 28.7), age 13–18 months (AOR 3.95), and anemia (AOR 2.65). Conclusions Most infants aged 1–24 months with suspected NEPE, had normal EEG, indicating limited diagnostic yield for epileptiform abnormalities. Age, specific triggers, and anemia can guide diagnosis and help to target EEG use to selected cases, thereby supporting more judicious resource utilization and avoiding unnecessary antiseizure medication.