Continuous EEG monitoring in Kenyan children with non-traumatic coma.
BACKGROUND: The aim of this study was to describe the EEG and clinical profile of seizures in children with non-traumatic coma, compare seizure detection by clinical observations with that by continuous EEG, and relate EEG features to outcome. METHODS: This prospective observational study was conduc...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2012
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| _version_ | 1797072018130075648 |
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| author | Gwer, S Idro, R Fegan, G Chengo, E Garrashi, H White, S Kirkham, F Newton, C |
| author_facet | Gwer, S Idro, R Fegan, G Chengo, E Garrashi, H White, S Kirkham, F Newton, C |
| author_sort | Gwer, S |
| collection | OXFORD |
| description | BACKGROUND: The aim of this study was to describe the EEG and clinical profile of seizures in children with non-traumatic coma, compare seizure detection by clinical observations with that by continuous EEG, and relate EEG features to outcome. METHODS: This prospective observational study was conducted at the paediatric high dependency unit of Kilifi District Hospital, Kenya. Children aged 9 months to 13 years presenting with acute coma were monitored by EEG for 72 h or until they regained consciousness or died. Poor outcome was defined as death or gross motor deficits at discharge. RESULTS: 82 children (median age 2.8 (IQR 2.0-3.9) years) were recruited. An initial medium EEG amplitude (100-300 mV) was associated with less risk of poor outcome compared to low amplitude (≤100 mV) (OR 0.2, 95% CI 0.1 to 0.7; p<0.01). 363 seizures in 28 (34%) children were observed: 240 (66%) were electrographic and 112 (31%) electroclinical. In 16 (20%) children, electrographic seizures were the only seizure types detected. The majority (63%) of electroclinical seizures had focal clinical features but appeared as generalised (79%) or focal with secondary generalisation (14%) on EEG. Occurrence of any seizure or status epilepticus during monitoring was associated with poor outcome (OR 3.2, 95% CI 1.2 to 8.7; p=0.02 and OR 4.5, 95% CI 1.3 to 15.3; p<0.01, respectively). CONCLUSION: Initial EEG background amplitude is prognostic in paediatric non-traumatic coma. Clinical observations do not detect two out of three seizures. Seizures and status epilepticus after admission are associated with poor outcome. |
| first_indexed | 2024-03-06T23:01:35Z |
| format | Journal article |
| id | oxford-uuid:624fe4ee-9247-4917-8520-f018e21307be |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:01:35Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:624fe4ee-9247-4917-8520-f018e21307be2022-03-26T18:05:23ZContinuous EEG monitoring in Kenyan children with non-traumatic coma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:624fe4ee-9247-4917-8520-f018e21307beEnglishSymplectic Elements at Oxford2012Gwer, SIdro, RFegan, GChengo, EGarrashi, HWhite, SKirkham, FNewton, CBACKGROUND: The aim of this study was to describe the EEG and clinical profile of seizures in children with non-traumatic coma, compare seizure detection by clinical observations with that by continuous EEG, and relate EEG features to outcome. METHODS: This prospective observational study was conducted at the paediatric high dependency unit of Kilifi District Hospital, Kenya. Children aged 9 months to 13 years presenting with acute coma were monitored by EEG for 72 h or until they regained consciousness or died. Poor outcome was defined as death or gross motor deficits at discharge. RESULTS: 82 children (median age 2.8 (IQR 2.0-3.9) years) were recruited. An initial medium EEG amplitude (100-300 mV) was associated with less risk of poor outcome compared to low amplitude (≤100 mV) (OR 0.2, 95% CI 0.1 to 0.7; p<0.01). 363 seizures in 28 (34%) children were observed: 240 (66%) were electrographic and 112 (31%) electroclinical. In 16 (20%) children, electrographic seizures were the only seizure types detected. The majority (63%) of electroclinical seizures had focal clinical features but appeared as generalised (79%) or focal with secondary generalisation (14%) on EEG. Occurrence of any seizure or status epilepticus during monitoring was associated with poor outcome (OR 3.2, 95% CI 1.2 to 8.7; p=0.02 and OR 4.5, 95% CI 1.3 to 15.3; p<0.01, respectively). CONCLUSION: Initial EEG background amplitude is prognostic in paediatric non-traumatic coma. Clinical observations do not detect two out of three seizures. Seizures and status epilepticus after admission are associated with poor outcome. |
| spellingShingle | Gwer, S Idro, R Fegan, G Chengo, E Garrashi, H White, S Kirkham, F Newton, C Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title | Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title_full | Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title_fullStr | Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title_full_unstemmed | Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title_short | Continuous EEG monitoring in Kenyan children with non-traumatic coma. |
| title_sort | continuous eeg monitoring in kenyan children with non traumatic coma |
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