Paroxysmal phenomena in severe disabled children with refractory seizures. From clinical to long-video-EEG processing data to re-examine suspect events.
To provide an estimate of the occurrence of misdiagnosis in paroxysmal events in institutionalized children with severe disabilities and refractory epilepsy. A multi-step diagnostic survey, from observational to long-term video-EEG monitoring was performed in 46 severe disabled children. Multirater...
| Publicado en: | Research in Developmental Disabilities Vol. 36; pp. 125 - 134 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Pergamon Press - An Imprint of Elsevier Science
Jan2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=99794026&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 99794026 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08914222 JJZ jtl: Research in Developmental Disabilities issn: 08914222 maglogo: N pubinfo: dt: Jan2015 vid: 36 pid: 2410 pub: Pergamon Press - An Imprint of Elsevier Science artinfo: ui: 99794026 99794026 NLM25462473 10.1016/j.ridd.2014.08.040 NLM25462473 99794026 ppf: 125 ppct: 9 formats: tig: atl: Paroxysmal phenomena in severe disabled children with refractory seizures. From clinical to long-video-EEG processing data to re-examine suspect events. aug: au: Arcieri, Salvatore Zanotta, Nicoletta Gnatkovsky, Vadym Avantaggiato, Paolo Formica, Francesca Epifanio, Roberta Angelini, Lucia Strazzer, Sandra Zucca, Claudio affil: Unit of Clinical Neurophysiology, Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20/A, 23842 Bosisio Parini, LC, Italy sug: ab: To provide an estimate of the occurrence of misdiagnosis in paroxysmal events in institutionalized children with severe disabilities and refractory epilepsy. A multi-step diagnostic survey, from observational to long-term video-EEG monitoring was performed in 46 severe disabled children. Multirater Kappa statistic was used to assess agreement between investigators and to individualize children who remained with dubious events. Subsequently, prolonged EEG-video monitoring analysis was performed in selected children to define phenomena due to seizures. A total of 128 video records were performed, 64 routine video-EEG and 27 long-monitoring video-EEG data were screened for detailed analysis. Thirty (21 female, 9 male) children (65%) with dubious seizures were identified by video records (concordance K=0.63). Of these, in 18 children (39%) seizures were excluded by routine video-EEG monitoring (K=0.86). Twelve children (26%) required accurate investigations with long-term video-EEG. In 5 children (11%), 3 symptomatic and 2 cryptogenic, very short and subtle seizures were confirmed by investigators concordance (K=0.83). Distinguishing paroxysmal phenomena is a challenge in children with severe disabilities; its most remarkable consequence is inappropriate pharmacological treatment and social costs. Our data suggest that the frequency of misdiagnosis could have been underestimated. The clinicians who manage children with severe disabilities and refractory epilepsy must remain alert to risk of an incorrect treatment. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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