Overuse of EEG and ECG in children with breath-holding spells and its implication for the management of the spells.

Autor: Hellström Schmidt S; Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.; Chilhood Cancer Center, Skåne University Hospital, Lund, Sweden., Smedenmark J; Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden., Jeremiasen I; The Paediatric Heart Center, Skåne University Hospital, Lund, Sweden., Sigurdsson B; Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Paediatric Neurology, Skåne University Hospital, Lund, Sweden., Eklund EA; Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.; Department of Paediatric Neurology, Skåne University Hospital, Lund, Sweden., Pronk CJ; Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.; Chilhood Cancer Center, Skåne University Hospital, Lund, Sweden.; Wallenberg Centre Molecular Medicine and Division Molecular Haematology, Lund University, Lund, Sweden.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2024 Feb; Vol. 113 (2), pp. 317-326. Date of Electronic Publication: 2023 Oct 31.
DOI: 10.1111/apa.17020
Abstrakt: Aim: Breath-holding spells (BHS) are common in children, but evidence-based clinical guidelines are lacking. We investigated a large population-based cohort of BHS patients, to propose a refined description of typical BHS and guidelines for its management.
Methods: In a cross-sectional retrospective study, patients diagnosed with BHS in Southern Sweden 2004-2018 were recruited. Disease characteristics and diagnostic data were collected from patient medical records.
Results: In total, 519 patients, mean age at diagnosis 19.8 ± 13.8 months with equal gender distribution, were included. In 48.3%, BHS had already been diagnosed after one spell. During spells, 78.0% of patients were unresponsive. For 71.5%, atonic, tonic, tonic-clonic or myoclonic seizures were reported, and 78.0% of patients had a spell lasting less than 1 min. Electroencephalography was conducted in 30.4% and Electrocardiography in 45.1%. Six children (3.8%) had a pathological electroencephalogram, four of which had concomitant epilepsy and only 0.9% of children had electrocardiogram findings suggesting pathology, none showing long QT syndrome.
Conclusion: Children with BHS were frequently subjected to unnecessary diagnostic interventions. We characterise a typical presentation of BHS and propose a management-algorithm, which is expected to reduce unnecessary usage of electroencephalography and electrocardiography.
(© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)
Databáze: MEDLINE
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