Staring spells in children: Descriptive features distinguishing epileptic and nonepileptic events - 09/09/11
Abstract |
Objective: To identify questions sensitive and specific for staring spells of epileptic (absence seizures [AS]) or nonepileptic etiology to increase the yield of history taking. Study design: A questionnaire was completed by parents of 40 children who presented with staring spells. Results from 17 children with AS and 23 with nonepileptic staring (NES) were compared. Results: Features with moderate sensitivity (43% to 56%) but high specificity (87% to 88%) for NES included preserved responsiveness to touch, lack of interruption of playing, and initial identification by a teacher or health professional. These features were more frequent in NES than in AS (P = .013, .016, .030). Body rocking occurred only in NES, but sensitivity was low (13%). Features with high specificity (91% to 100%) for AS included limb twitches, upward eye movements, and urinary incontinence; but sensitivities were low (13% to 35%). Conclusion: In children with normal interictal electroencephalography findings and without neurologic disease, staring spells are most likely nonepileptic when parents report preserved responsiveness to touch, body rocking, or initial identification by a teacher or health professional without limb twitches, upward eye movements, interruption of play, or urinary incontinence. In these cases a diagnosis of NES may be confidently applied, with confirmation based on long-term follow-up. (J Pediatr 1998;133:660-3)
Le texte complet de cet article est disponible en PDF.Abbreviations : AS, EEG, NES
Plan
| From the Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio. Drs Rosenow and Hamer are now at the Neurologische Universitätsklinik, Marburg, Germany. |
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| Reprint requests: Elaine Wyllie, MD, Department of Neurology, S51, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. |
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| 0022-3476/98/$5.00 + 0 9/21/94315 |
Vol 133 - N° 5
P. 660-663 - novembre 1998 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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