PAPEL DE LA MONITORIZACION ELECTROENCEFALOGRAFICA CONTINUA EN EL DIAGNOSTICO DE LA EPILEPSIA PEDIATRICA.

The diagnosis of epilepsy is basically clinical, but it frequently raises the differential diagnosis with non-epileptic events. The development of continuous EEG monitoring (CEEGM) in the past decades has allowed a better diagnosis of epileptic patients of all ages. In this paper we review the data...

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Publicado en:Medicina (Buenos Aires) Vol. 69; no. 1; pp. 92 - 101
Autores principales: Legido, Agustin, Valencia, Ignacio
Formato: Artículo
Publicado: Medicina (Buenos Aires) 2009
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Acceso en línea:Ver este registro en EBSCOhost
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        au:
          Legido, Agustin
          Valencia, Ignacio
        affil: Sección de Neurología, Departamento de Pediatría, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia PA, USA
      su:
        Medical research
        Electroencephalography
        Childhood epilepsy
        Diagnosis of brain diseases
        Surgery
        Hypertensive encephalopathy
        Intensive care units
        Brain function localization
        Medical care
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        subj:
          Medical research
          Electroencephalography
          Childhood epilepsy
          Diagnosis of brain diseases
          Surgery
          Hypertensive encephalopathy
          Intensive care units
          Brain function localization
          Medical care
      keyword:
        children
        continuous EEG monitoring
        electroencephalogram
        epilepsy
        video EEG
        electroencefalograma
        epilepsia
        monitorización EEG continua
        niños
        video EEG
      ab:
        The diagnosis of epilepsy is basically clinical, but it frequently raises the differential diagnosis with non-epileptic events. The development of continuous EEG monitoring (CEEGM) in the past decades has allowed a better diagnosis of epileptic patients of all ages. In this paper we review the data available in the literature about the efficacy of the different modalities of CEEGM in the diagnosis of pediatric epilepsy, emphasizing our personal experience. In our studies the ambulatory CEEGM supplemented with video allowed to answer the question that prompted its request in 80% of patients diagnosed with epilepsy and in 83% of those with the suspected diagnosis of epilepsy. With ambulatory computer-assisted CEEGM those figures were 88% and 89%, respectively, and with inpatient video-CEEGM they were 82% and 51%, respectively. The latter is crucial in the evaluation of epilepsy patients who are candidates for surgical treatment. Inpatient video-CEEGM is also very important in the management of patients with acute encephalopathies admitted to the Intensive Care Units. Both, ambulatory or inpatient CEEGM, are very useful in the differential diagnosis of clinical epileptic versus non-epileptic events, as well as in the confirmation of the type of epilepsy or epileptic syndrome. The development of technological advances and new EEG modalities in the future will help to continue to consider electroencephalography as a very important technique in the study of brain function in patients with acute or chronic encephalopathies.
        El diagnóstico de la epilepsia es fundamentalmente clínico, pero frecuentemente se plantea el diagnóstico diferencial con fenómenos no epilépticos. El desarrollo de la monitorización EEG continua (MEEGC) en las últimas dos décadas ha permitido mejorar el diagnóstico de pacientes epilépticos de todas las edades. En este trabajo se revisan los datos de la literatura sobre la eficacia de los distintos tipos de MEEGC en el diagnóstico de la epilepsia pediátrica, resaltando especialmente nuestra experiencia personal. En nuestros estudios, la MEEGC ambulatoria suplementada con video permitió contestar la pregunta que determinó su petición en el 80% de pacientes diagnosticados de epilepsia y en el 83% de aquéllos con sospecha diagnóstica de epilepsia. Con la MEEGC ambulatoria asistida por ordenador, dichas cifras fueron 88% y 89%, respectivamente y con la MEEGC intrahospitalaria con video fueron 82% y 51%, respectivamente. La MEEGC intrahospitalaria con video es crucial en la evaluación de pacientes con epilepsia, candidatos al tratamiento quirúrgico. La MEEGC es también importante en pacientes con encefalopatías agudas ingresados en las unidades de cuidados intensivos. La MEEGC, tanto ambulatoria como intrahospitalaria, es muy útil en el diagnóstico diferencial de fenómenos clínicos epilépticos y no epilépticos y en la confirmación del tipo de epilepsia o síndrome epiléptico. Los avances tecnológicos y el desarrollo de nuevas modalidades de EEG en el futuro, harán que la electroencefalografía siga siendo una técnica muy importante en el estudio de la función cerebral en pacientes con enfermedades neurológicas agudas o crónicas.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: Spanish
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